Wednesday, April 25, 2018

The Power of Persuasion

We are impacted by persuasion every day. Just turn on the television and within a few minutes, you’ve watched at least one commercial, if not more, advertising a sizeable discount if you call a toll-free number, log-on to a website, or run on down...

What a Pain

Today’s “Fraud of the Day” is based on an article entitled, “Daphne pain doctor pleads guilty to healthcare fraud, money laundering,” posted on A former pain doctor, who operated in Baldwin County, pleaded guilty to federal charges for defrauding Medicaid.

Medicare Manicures

Ocala podiatrist Dr. Michael Rotstein, 55, pleaded guilty on Monday to one count of healthcare fraud. Rotstein billed Medicare and TRICARE for a service that he called “removal of skin and muscle,” but which federal prosecutors said often was just “routine foot care, including the clipping of toenails.”

Reversal of Fortune

Some nine million members and veterans of the nation’s military services receive medical coverage from a U.S. government program called TRICARE. It’s a system built on trust — making it an easy mark for seasoned South Florida pharmacist Serge Francois, prosecutors say. Francois, 51, stood trial over the past month on charges of fleecing tens of millions from the taxpayer-funded military program to buy the former Broward County mansion of Hollywood megastar Dwayne “The Rock” Johnson.

The Opioid Crisis: When Healthcare Fraud Turns Deadly

The Opioid Crisis is now a Public Health Emergency. Combating the crisis and the criminals using fraud to perpetrate it (and often using taxpayer-funded dollars to do so), is critical. It is going to take data from multiple sources – providers, medical claims, pharmacy claims, public records, law enforcement records management system, computer-aided dispatch and more – to win. Siloed data will be the enemy of success, but data sharing will enable success.


Today’s “Fraud of the Day” is based on an article entitled, “Doctor with history of maiming patients sentenced to 35 years in $373 million home health scheme” posted by

Signing Off On Fraud

Before signing your name, it’s really important to know exactly what you are agreeing to. An Iowa physician signed off on more than 1,000 prescriptions that caused Tricare, the healthcare program for America’s military members, to be billed for more than $4.4 million in...


The U.S. Food and Drug Administration (FDA) exists to ensure public health is protected. The agency ensures “the safety, efficacy and security of human and veterinary drugs, biological products and medical devices.” (They are also responsible for ensuring the safety of the nation’s food...

One for the History Books

Today’s “Fraud of the Day” is based on an article entitled, “Owner of Dallas Health Care Company Gets 17 Years in Federal Prison for Role in Huge Fraud” published by Dallas Observer. U.S. District Judge Sam Lindsay sentenced the owner of a Dallas home health care company to 17 years in federal prison.

Rolling Away with Fraud

The durable medical equipment industry is rife with power wheelchair fraud. In fact, the Centers for Medicare and Medicaid Services have seen an increase of nearly 450 percent in spending over the past four years. (All of that cannot possibly be legit.) Today’s “Fraud...

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