Whistleblower lawsuits: How to avoid becoming a target

Earlier this month, three former managers of AIDS Healthcare Foundation Inc. (AHF) filed federal and state Whistleblower Act claims against their former employer. They allege that the nation’s largest supplier of HIV/AIDS medical care participated in patient referral kickbacks to the tune of at least $20 million since 2010. All three plaintiffs held management positions […]

Feds use data analytics to detect and investigate Medicare fraud

There have been countless stories in the news about how the federal government has gone about combating Medicare fraud. Still, every year the battle rages on. Between 2012 and 2014, the Office of the Inspector General’s investigations have resulted in $14.8 billion in investigative receivables (dollars ordered or agreed to be paid to government programs […]

CMS cracking down on fraudsters

Federal agencies are stepping up their efforts to go after providers who engage in healthcare fraud and abuse. On Dec. 3, the Centers for Medicare & Medicaid services issued new rules designed to crack down on what the agency refers to as “bad actors,” as part of an effort to increase oversight of Medicare providers, […]