Six blind men lived in a village visited by an elephant. They had no idea what an elephant was, and so they--being curious and bold--decided to touch the animal to find out. (Note to readers: Do not...
Robert Gordon Orr is a retired professional ice hockey player who led the Boston Bruins and Chicago Black Hawks. He's a sports legend. What set him apart was the completeness of his game, his...
Fifteen California medical professionals were indicted last week in a $25 million dollar workers' compensation scam that prosecutors associate with a child's death, the Associated Press reported.
Offering further proof that health insurance fraud and abuse aren't victimless crimes, recent scams share a theme of patient exploitation and endangerment. Here are four prominent cons worth noting.
Health insurance programs have lost hundreds of millions of dollars due to fraud by organized crime rings. To learn how payers can recognize and respond effectively to this threat, FierceHealthPayer: Anti-Fraud spoke to Rebecca Kettelle Pyne, a trial attorney in the organized crime and gang section of the criminal division of the U.S. Department of Justice (DoJ).
As Memorial Day nears, I remember the saddest day of my professional life. That was when the medical director at my former company died. I don't know old he was, but his life ended early as a...
FierceHealthPayer:Anti-Fraud recently spoke to Jack Price (pictured) about how payers can create high-performance special investigations units (SIUs) to control fraud, waste and abuse. A former law enforcement officer, Price is a consultant with more than 20 years of experience developing, managing and leading SIUs in the life and health insurance industries.
The Office of Inspector General proposed a new rule to strengthen its authority to exclude providers from federal healthcare programs.
Monitoring home healthcare and hospice claims is a program integrity priority due to continuing fraud, abuse and general noncompliance involving such benefits. How can payers fight these trends? FierceHealthPayer: Anti-Fraud spoke to Sean McKenna, J.D., to find out.
My credit card company called me awhile back asking if I had just bought diamond jewelry in Barbados. With powerful analytic subtlety, the bank's anti-fraud unit flagged this purchase as a tad...
- South Dakota Critical Access Hospital Finances $6.2 Million Long-Term-Care Addition
- Fitch Downgrades KershawHealth (SC) Revs to 'BBB'; Outlook Revised to Stable
- Pasadena Magazine’s 2014 Top Doctors Survey Names 135 Physicians from Children’s Hospital Los Angeles
- NextGen Healthcare to Expand RCM Services Footprint Through Agreement with Putnam County Memorial Hospital
- Harbin Clinic and Cigna Start Collaborative Care Program to Improve Health and Lower Costs
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