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...
CMS recently updated its Medicare fraud and improper payment audit process to target providers and suppliers who continually demonstrate high medical billing error rates, according to the federal...
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...
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...
The Office of the Inspector General (OIG) recently found the most significant management and performance challenges facing the Department of Health and Human Services (HHS), including financial...
A Georgia-area provider has recently been sentenced to three years and two months in prison stemming from a healthcare fraud case, the Department of Justice (DoJ) reported.
Robert E. Windsor of Georgia...
The former chief executive officer of a South Carolina-based healthcare system agreed to pay $1 million and be excluded from federal healthcare programs for four years to resolve a 2013 Medicare fraud...
Kindred Healthcare, Inc., the country’s largest provider of post-acute care, recently paid more than $3 million for failing to comply with a Medicare fraud resolution agreement. It represents the...
Medicare fraud cases have the potential to drain the federal healthcare program of millions of dollars while also putting beneficiaries at risk of receiving unnecessary or low-quality care. In response,...
