Monday, August 20, 2018

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.

Maimed

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 DallesNews.com.

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...

Misconstrued

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...

Putting the Brakes on Fraud

There are a variety of ways to commit Medicare fraud including billing for unnecessary services or services not provided, up-coding or double-billing, or offering or accepting kickbacks, just to name a few. Today 's fraudsters, who were man and wife, tried a different tactic...

Should Have Known Better

Sometimes, people are oblivious that they are doing something wrong. Then, there are folks who know what they are doing is wrong, and continue to do it anyway. The latter is the case for an Ohio woman and her son who ran two home...

Loaded Diapers

Diapers have been known to hold a lot, and a mother-daughter team decided to use them to hold something a little different. The diaper duo concealed approximately $2.4 million in cash in diapers and baby towels that were hidden in their luggage on a...

Three-Ring Circus

Three-ring circuses are famous for having multiple performing acts going on at the same time. Similarly, a healthcare clinic manager ran a Medicaid and Medicare fraud ring at three clinics across New York City. Just as it can be hard to focus in on...

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