Posts Tagged ‘Medicaid fraud’
Father and Son Clinic Owners to Pay $2 million to Settle False Claims Act, Anti-Kickback Statute and PPP Fraud Allegations
The owners Amerihealth in eastern Idaho have agreed to pay $2 million to settle allegations they violated the False Claims Act.
Read MoreConviction in $9.5M Genetic Testing Healthcare Fraud Scheme
A Chicago physician licensed to practice in several states recently was convicted by a federal jury in Nashville, Tenn. in a healthcare fraud scheme of conspiracy to violate the federal Anti-Kickback Statute following a two-week trial. Doctor Acted as a Consulting Provider for Telemedicine Companies Dr. Benjamin T. Toh was indicted in December 2022 for…
Read MoreEighteen Charged in COVID-related Healthcare Fraud Resulting in $490M in False Billings and Theft
Eighteen Charged in COVID-related Healthcare Fraud Resulting in $490M in False Billings and Theft
Read MoreFormer Senior Living CEO Indicted on ALF and Skilled Nursing Facility Fraud
The former CEO of a New Jersey-based company that owned and operated 24 skilled nursing facilities and nine assisted living facilities in Wisconsin and Michigan recently was indicted on charges of healthcare fraud, six counts of wire fraud, three counts of mail fraud, conspiracy to commit tax fraud, and conspiracy to commit money laundering. The…
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 MoreReport: Many High-Risk Medicaid Providers Not Undergoing Critical Background Checks
Eighteen states failed to properly screen high-risk providers before allowing them to receive Medicaid payments by the July 2018 deadline and 13 of those states had not yet complied by Jan. 1, 2019. Those are the findings from a recently released report by the U.S. Department of Health and Human Services Office of Inspector General.…
Read MoreJune 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 data mining is uncovering healthcare fraud
What does your data say about your healthcare practice? Does it show that you bill considerably more than your colleagues for certain types of procedures? What about your facility? Is it performing more of a particular procedure than nearby competitors? These days, healthcare fraud investigators increasingly rely on data to root out healthcare fraud. They…
Read MoreFlorida ALFs latest target of Medicaid fraud investigators
Assisted Living Facilities (ALFs), and the patient placement agencies with which they work, have become the latest target of Florida’s Medicaid Fraud Control Unit (MFCU) investigators. Recently, these agencies have been conducting interviews with ALF owners, managers and marketing personnel at facilities where they suspect possible kickbacks in violations of the Florida Patient Brokering Statute…
Read MoreHome healthcare agencies, aides top fraud list
Home healthcare agencies and home healthcare aides topped the list of providers with the largest number of healthcare fraud convictions in 2014, according to a report released last month by the HHS Office of the Inspector General. Of the more than $1.9 billion recovered in total civil judgments and settlements, the federal government recovered $186…
Read More