Tuesday, January 21, 2020

Home-Health Fraud

People who qualify for Medicaid’s home healthcare coverage are some of the most vulnerable among us. They are impoverished or disabled and count on home-health workers to help them with basic needs. But that doesn’t stop some people from stealing from the program and...

Hypocrite

Depending on the labor and ingredients required, costs for compounded medications can be quite expensive. A Georgia podiatrist committed healthcare fraud by participating in a kickback scheme that generated patients who supposedly needed compounded medications. He collaborated with a pharmacy, who billed the unnecessary...

Beware of Rising Premiums

A Washington, D.C.-based insurance broker was in a good position to get rich off one of the U.S.’s biggest health insurance companies. That is, until the law caught up with him. Now, he’s facing prison time for healthcare fraud and identity theft. A federal jury...

Go Big or Go Home

Most of the workers’ compensation fraud stories covered on FraudOfTheDay.com tend to involve small to medium-sized businesses who try to defraud state workers’ compensation programs or private insurers by underreporting payroll to avoid high insurance premiums. (Or they simply don’t provide workers’ compensation insurance...

Fraud Vessels

Blood vessels are tubular structures that carry blood throughout the body to tissues and organs. Veins are blood vessels that carry oxygen-depleted blood toward the heart. A Missouri doctor and his company used veins as a vessel to carry out a healthcare fraud scheme...

Detecting Patterns

Fraud schemes are usually detected when a pattern becomes apparent. Such is the case for a Murfreesboro, Tennessee dentist, who continued to commit healthcare fraud for more than four years by using the same pattern of fraudulent billing practices. The dentist in today’s fraud...

Compounding the Problem

Reimbursement rates for compounded drug prescriptions are high because a lot of work goes into combining and mixing the ingredients of a medication that is made specifically for a patient’s particular needs. These high reimbursement rates are a huge incentive for fraudsters to scam...

Taking the Government on a Ride

The owners of a Columbus, Ohio medical transportation company attempted to take three government agencies on a very costly ride. But, the Medicare and Medicaid programs and the Internal Revenue Service (IRS) put a stop payment on the $3.3 million fare to cover the...

Fraudulent Air

According to the Mayo Clinic, hyperbaric oxygen therapy (HBOT) is used to treat decompression sickness, a hazard of scuba diving. It can also be used to treat serious infections, air bubbles in veins and arteries, and wounds that won’t heal. The owner of a...

Rx for Fraud

A 52-year-old Decatur, Georgia man was recently sentenced to prison for committing healthcare fraud. He defrauded TRICARE and other insurance companies out of more than $6.5 million by using a Pensacola, Florida pharmacy to fill fraudulent prescriptions. While many instances of prescription fraud involve...

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