Topic:
Fraud Prevention and Detection
Latest Headlines
Latest Headlines
Aetna investigates neuromonitoring arrangements
One of the nation's largest health insurance providers is questioning the relationship between neurosurgeons and neuromonitoring companies that track a patient's nervous system during complex operations, according to the Austin American-Statesman.
Five more arrested in widespread $600M kickback scheme
The former chief financial officer at a Southern California hospital and two orthopedic surgeons are among five individuals arrested and charged with participating in a widespread fraud scheme that lasted eight years and led to more than half a billion dollars in false claims.
Insurance broker sentenced to three years for stealing $10M from Aetna
An insurance broker from a popular Vermont ski destination will spend three years in prison for stealing millions in insurance premiums that were supposed to be transferred to Aetna.
NHCAA conference focuses on the future of fraud enforcement
As improper payment rates increase across the board, federal officials are targeting areas of healthcare that are particularly vulnerable to fraud, including prescription drug schemes involving non-controlled drugs and high-priced specialty drugs, according to reports from the National Health Care Anti-Fraud Association's annual conference.
Novartis finalizes $390 million kickback settlement
After agreeing "in principle" to settle kickback allegations last month, Novartis finalized the $390 million deal, ending a drawn out legal battled that has led to nearly half a billion dollars in recoveries, according to a release from the Department of Justice (DOJ).
For fraud enforcement, strength in numbers takes on a double meaning
Strength in numbers. It's a tried and true adage that's so universal that it's ben used by high-ranking generals as a wartime strategy, or a pack of disgruntled kindergarteners standing up to the schoolyard bully. For those charged with fighting fraud, it's a maxim that holds true in more ways than one. Data analytics provides the building blocks for fraud detection, but increasingly, states are forming their own healthcare fraud task force to employ a more simplistic approach to fraud enforcement.
In Georgia, strict fraud enforcement raises concerns about access to care
Providers in Atlanta are raising concerns about the state's approach to fraud enforcement, citing multiple cases in which the state has levied heavy fines against facilities for making small clerical errors, according to WSB-TV 2 in Atlanta.
Following $450M settlement, DaVita faces another fraud investigation
After shelling out more than $800 million over the past 13 months to settle False Claims Act and kickback violations, DaVita Healthcare Partners Inc. is facing more federal scrutiny.
As much as 20 percent of mental health funds lost to fraud, waste, abuse
Mental health fraud, waste and abuse cost Medicare and Medicaid as much as $8 billion annually, which translates to a 20 percent improper payment rate, according to estimates from mental health researchers.
Home health owners found guilty for largest fraud scheme in DC's history
Husband and wife owners of a home care agency in Washington D.C. were convicted for their role in the largest fraud scheme recorded in the nation's capital.
