OIG Unveils Fraud Risk Indicator

The Health and Human Services Office of Inspector General has launched a new initiative designed to draw attention to those healthcare providers it considers to be high risk for committing healthcare fraud after having been charged under the False Claims Act. The OIG posted this Fraud Risk Indicator on its website after Gregory Demske, the […]

Medical Device Maker Settles False Claims Allegations, Agrees to Pay $12.5M

A New York-based medical device manufacturer has agreed to pay $12.5 million to settle allegations it caused healthcare providers to submit false claims to federal healthcare programs relating to the use of two of its medical devices. AngioDynamics Inc. was accused of causing false claims to be submitted to Medicare, Medicaid, TRICARE, and other federal […]

Common Healthcare Fraud Schemes

Last month’s indictment of more than 600 people nationwide in what the feds dubbed “the largest healthcare fraud takedown in history,” should serve as a warning that the government is serious about cracking down on those who abuse the system. As we wrote about in June, of the 601 defendants charged, 165 were medical professionals […]

Doctors, Nurses, Other Healthcare Pros Rounded up in Opioid and Medicare Fraud Sweep

Doctors, nurses, addiction treatment professionals, pharmacists and hundreds of others are among the 601 people across 58 federal districts charged this week in what the Justice Department is calling “the largest national healthcare fraud enforcement action” in its history. The fraud resulted in more than $2 billion in losses. Of those 601, more than 162 […]

OIG Report: Medicare Paid out Millions in Improper Payments to Chiropractors

A report issued this month by the Office of Inspector General (OIG) finds that about half of Medicare payments made for chiropractic services between 2010 and 2015 were improper – that is they either were not medically necessary, not billed properly or not sufficiently documented. The report, titled “Medicare needs better controls to prevent fraud, […]

Second FCA Whistleblower Case Dismissed – What’s a Lawyer to Do?

For the second time in the last few weeks, a Florida district court judge has dismissed a whistleblower lawsuit filed against a healthcare company alleging fraud. The most recent dismissal, which took place on February 6, was of a lawsuit against electronic software company Epic that alleged it had overbilled for anesthesia procedures. In dismissing […]

Judge: Third Try Won’t be the Charm for Whistleblower

A U.S. District Court Judge earlier this month tossed a whistleblower lawsuit filed against a Florida compounding pharmacy finding that the former sales representative who filed the initial lawsuit in 2013 failed to make sufficient pleadings. However, defendant RS Compounding LLC in Tampa is not completely off the hook. The government intervened in, and the […]

GAO: CMS Fraud Prevention Working

The days of “pay and chase” in the world of healthcare fraud are waning thanks to fraud prevention methods that the Centers for Medicare and Medicaid Services have put into place. A newly released report from the Government Accountability Office (GAO) finds that Fraud Prevention System (FPS), which analyzes fee-for-service claims to identify healthcare providers […]

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 […]

Genesis Healthcare Settlement Another Example of Government’s Anti-Fraud Campaign

Whatever else is taking place in the nation’s capital these days, one thing is for certain, there is no letup in the government’s crackdown on healthcare fraud. This is made clear by the continued announcements of multimillion-dollar settlements coming from various fraud-fighting agencies. One of the more recent settlements involves Genesis Healthcare, Inc., a Kennett […]

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