Topic:
Fraud Prevention and Detection
Latest Headlines
Latest Headlines
National wound care provider accused of using 'superbills'
A national wound care provider, Healogics, is facing allegations from former employees that the company billed for unnecessary procedures, implicating clincs and hospital partners in 29 different states, according to the Jacksonville Business Journal.
Social Security numbers on Medicare cards: A well-worn welcome mat for fraud
The issue of including Social Security numbers of Medicare beneficiary cards has been discussed for more than four decades, including repeated warnings from the Government Accountability Office. Despite those warnings, the Centers for Medicare & Medicaid Services has failed to take even incremental steps to remove the identifying numbers, contributing to pervasive identity theft that exploits seniors and leads to millions in healthcare fraud schemes.
Senate Committee hearing highlights identity theft risks among Medicare beneficiaries
Expert testimony at aSenate Committee on Aging hearing outlined how identity theft can lead to multi-million dollar fraud schemes--and the preventative measures that can protect personal health information.
Scammers take advantage of Medicare beneficiaries in Chicago
Scammers commonly referred to as "marketers" are taking advantage of Medicaid beneficiaries throughout Chicago, offering cash kickbacks or free services, while billing for services that were never provided, according to WBEZ Chicago.
Study identifies $11M in Medicaid waste, fraud and abuse in Delaware
A much-anticipated review of the Delaware's Medicaid program revealed $11 million in potential fraud, waste, and abuse over the last three years, according to the Associated Press.
Salomon Melgen, plus payment data, put ophthalmologists in the hot seat
Two multi-million dollar cases against two ophthalmologists, including the headline-grabbing Salomon Melgen, have thrown the specialty into the regulatory hot seat. Add Melgen's high-profile case to payment data that lists Medicare payments to ophthalmologists that reach eight figures and an OIG report that identified $171 million in questionable claims, and you've got a recipe for additional federal scrutiny, plus potentially more fraud cases involving ophthalmologists.
Distinct enforcement themes emerge at AHLA fraud conference
Last week's Fraud and Compliance Forum, hosted by the American Health Lawyers Association, outlined current and future fraud enforcement trends straight from the mouths of OIG officials.
OIG identifies $76 million in questionable chiropractic claims
The government isn't doing enough to prevent improper chiropractic payments, particularly claims involving "maintenance therapy," according to a new OIG report, particularly claims involving "maintenance therapy."
Anatomy of a fraud bust: Collaboration creates efficiency
With more large-scale, multi-million dollar fraud schemes surfacing across the country, enforcement officials are utilizing Medicare Fraud Strike Force teams to dismantle entire fraud operations. Rob Howard, assistant special agent in charge with the FBI in Detroit, explains how fraud enforcement officials discover and unravel large-scale schemes.
OIG: Medicare paid $30 million for untraceable ambulance rides
Medicare spent more than $30 million during the first half of 2012 on ambulance transports for patients that appear to be ghosts on paper, according to a new report released by the Office of Inspector General Tuesday.
