Banner Health, one of the largest non-profit hospital systems in the country, recently agreed to pay $18 million to the federal government to resolve Medicare fraud allegations involving 12 of its...
For every dollar the federal government spent on combatting healthcare fraud and abuse in the last three years, the government recovered $4, HHS recently reported.
While federal healthcare fraud...
A group of five provider organizations specializing in orthopedic surgeries or anesthesiology recently paid $3.2 million to the federal government to resolve healthcare fraud allegations involving...
A recent Department of Justice (DoJ) memo limiting the use of regulatory guidance to pursue affirmative civil enforcement cases could alter the federal government’s approach to healthcare fraud...
A federal jury in South Carolina recently found the former CEO of Health Diagnostic Laboratory and the owners of the healthcare organization’s marketing partner liable in a Medicare fraud case...
In an effort to reduce Medicare fraud, CMS announced in a new rule that it will extend a moratorium on enrollment of new Medicare home health agencies in Florida, Illinois, Michigan, and Texas. The...
The country’s two largest public-private healthcare payment systems, the VA and CMS, recently announced that they will partner to reduce healthcare fraud, waste, and abuse for veterans using data...
Two physician groups will pay over $33 million to settle healthcare fraud allegations that the groups received illegal kickback payments for patient referrals to hospitals owned by former Health...
CMS demonstrates a commitment to preventing and combating Medicaid and Medicare fraud, but the federal agency’s anti-fraud efforts only partially align with the Government Accountability...
The federal government filed a lawsuit against the two owners of Gateway Health Systems in Chicago for their involvement in a Medicare fraud scheme that cost the federal healthcare program millions,...
A physician from Oklahoma recently agreed to pay $580,000 to settle a Medicare fraud case in which the federal government alleged that he submitted false claims to the federal healthcare program, the...
Healthcare fraud and abuse cases cost the industry billions of dollars a year. Without processes in place to detect and prevent fraudulent activities, healthcare providers could face an investigation that may cost them their reputation and...
Los Angeles-based Pacific Alliance Medical Center recently agreed to pay $42 million in order to settle an ongoing healthcare fraud case involving improper financial relationships between the acute...
Healthcare fraud prevention and prosecution will continue to be a major area of focus for the Department of Justice (DoJ), Acting Assistant Attorney General Kenneth A. Blanco recently told the American...
The Office of the Inspector General (OIG) recently published guidelines on how healthcare organizations can measure the effectiveness of their healthcare fraud compliance programs.
The resource guide...
A dentist from Georgia faces one and a half years in federal prison after she reportedly participated in a Medicaid fraud scheme totaling almost $1 million, the Department of Justice (DoJ) recently...
A New York-based healthcare clinic manager recently pled guilty for his role in a Medicaid and Medicare fraud ring involving three clinics across New York City. The scheme to defraud federal healthcare...
The Department of Justice (DoJ) recently announced the indictment of Tenet Healthcare Corporation’s former senior vice president of operations for his alleged participation in a healthcare fraud...
Approximately $36 billion in Medicaid reimbursements made to providers and suppliers in 2016 were improper, a 9.8 percent increase from last year’s Medicaid improper payment amount, the...
Through healthcare fraud cases and settlements in 2016, Department of Health and Human Services (HHS) and Department of Justice (DoJ) initiatives returned over $3.3 billion to the federal government...
