Thursday, November 21, 2019

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...

Overinflated

A Newton, Massachusetts doctor submitted overinflated claims to Medicare and MassHealth, the Massachusetts Medicaid program, for care he supposedly provided to nursing home patients. The consequences of his overblown actions require him to pay the two government healthcare programs $680,000 to resolve allegations that...

Sticky Situation

Acupuncture, which was developed more than a thousand years ago in China, is an alternative medical practice that uses needles to alleviate pain and nausea or treat chronic health conditions. (For those who do not like needles, physical therapy and chiropractic treatment can also provide...

Loud and Clear

The False Claims Act (FCA) came about in 1863 when Congress became concerned that suppliers serving the Union Army during the Civil War were defrauding the Army. At that time, the FCA required any person who knowingly submitted false claims to the government to pay $2,000...

Deliberate

Medicare and Medicaid beneficiaries who receive home healthcare services are required to use providers approved by the Centers for Medicare and Medicaid Services (CMS). (CMS is explicit on compliance requirements so that beneficiaries receive good healthcare and providers receive payment for their claims in a timely...

Allergic to Fraud

For allergy sufferers who do not like needles, allergy drops are an alternative to in-office shots. Some research reports show that the benefits of allergy drops can be similar to allergy shots, except most drops are not approved by the Food and Drug Administration (FDA). That’s...

Minimize

For some people, living a minimalist lifestyle means having a happier life. This is not so for the owner of a pharmacy in Red Bud, Illinois and his wife. After the pharmacist was charged with healthcare fraud, his wife tried to minimize their connection with the...

Extra Padding

There are several places where it’s nice to have extra padding. For some, a soft foam topper on a firm mattress could help facilitate a more comfortable night of rest. Individuals who regularly travel from coast to coast on a bare-bones economy airline might prefer a...

This One’s a Whopper

Whopper, colossal, enormous, gargantuan – these are all words that could describe a $1 billion healthcare fraud scheme masterminded by the owner of a Miami, Florida-based healthcare facility empire. The players in this game of fraud include the executive’s father, many medical professionals, a hospital administrator, two...

Communication is Key

Communication is Key Good communication skills are necessary to have a successful marriage. But due to some miscommunication between a New Haven, Connecticut doctor and her husband, they are now responsible for their involvement in a healthcare fraud scheme that stole $1.5 million...

Get Your Fraud Fix!

Five days a week wake up to the most current fraud article in your mailbox.