Posts Tagged ‘healthcare fraud defense’
DOJ recovers $5.6B in FCA Settlements/Judgments
The U.S. Department of Justice (DOJ) recently announced it had taken in more than $5.6 billion in False Claims Act (FCA) settlements and judgments in the fiscal year ending Sept. 30, 2021. That’s the second largest annual total in the history of the FCA and the largest in seven years. In FY 2020, DOJ’s recoveries…
Read MoreDOJ Launches Task Force Targeting COVID-19 Relief Fraud
Healthcare has always been ripe for fraud, so it’s no surprise that the COVID-19 pandemic created a wellspring of opportunities for those looking to make money off a tragedy. But getting away with it likely will become a lot harder, thanks to the creation of the COVID-19 Fraud Enforcement Task Force. Launched in May by…
Read MoreFeds Recover $2.6B in 2019
The federal government recently announced it won or negotiated more than $2.6 billion in healthcare fraud adjustments and settlements during the last fiscal year (2019). As a result of its efforts, as well as those of preceding years, approximately $3.6 billion was recovered. Of that total, approximately $2.5 billion was transferred to the Medicare Trust…
Read MoreDOJ Recovers $2.6B in Healthcare Fraud Settlements, Judgments in 2019
The federal government said it was making healthcare fraud a priority, and from the numbers just released by the U.S. Department of Justice, it appears to be bearing fruit. The DOJ announced last week that it recovered more than $3 billion in settlements and judgments from civil cases involving fraud and false claims in the…
Read MoreA September to Remember for Healthcare Fraud
June a busy month for healthcare fraud enforcement
Individual physicians, medical billers, DME manufacturers, healthcare executives and even entire healthcare systems were on the receiving end of the U.S. Department of Health and Human Services Office of the Inspector General’s (OIG) enforcement efforts last month. In fact, there were 39 actions announced by the IG’s office in June, up from 35 in May…
Read MoreHow can investigators predict healthcare fraud?
Predictive modeling is a term that has been used a great deal lately in the context of healthcare fraud. In a nutshell, predictive modeling is the area of data mining concerned with forecasting probabilities and trends. Here in South Florida, many of us are familiar with its use through the forecasting of hurricanes. In the…
Read MoreFeds target healthcare fraud by looking for outliers
Last week, the U.S. Department of Justice announced the largest healthcare fraud takedown in its history. Approximately 300 defendants in 36 federal districts, including South Florida, were charged with engaging in fraudulent billings to the tune of more than $900 million. Charges included: conspiracy to commit healthcare fraud, violations of the anti-kickback statutes, money laundering…
Read MoreHealthcare Fraud and Abuse Crackdown Not Slowing as Evidenced by Recent Cases
The federal government has been busy since the beginning of the year announcing arrests, convictions and settlements relating to healthcare fraud and abuse. The activities relate to violations of the Stark Law, anti-kickback law and federal False Claims Act, and there appears to be no end in sight. Whether it’s home health, transportation, durable medical…
Read MoreGovernment recovers $1.9 billion in healthcare fraud judgments and settlements in FY 2015
A newly released report by the Health Care Fraud and Abuse Control Program (HCFAC) shows that the federal government won or negotiated more than $1.9 billion in healthcare fraud judgments and settlements in fiscal year 2015. As a result of these efforts, as well as those of preceding years, in fiscal year 2015, approximately $2.4…
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