Saturday, December 7, 2019
Home Healthcare Fraud

Healthcare Fraud

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.

Putting Fraud to Bed

According to the American Sleep Association (ASA), between 50 and 70 million adults in the U.S. have a sleep disorder. The former owner of multiple sleep study clinics in Maryland and Northern Virginia capitalized on those statistics by causing a loss of more than...

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.

The Doctor Will See You Now

Doctor visits are expensive in terms of time and money. It’s not uncommon to arrive on time for an appointment, then be kept waiting for what seems like forever to only get a few minutes with a physician. According to a survey on how...

Drowning in Pills

According to the Centers for Disease Control and Prevention, opioid prescriptions are linked to more than 40 percent of all U.S. opioid overdose deaths. (More than 200,000 people died from prescription opioid overdoses between 1999 and 2016. Just during 2016, more than 46 people...

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...

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.

Monkey See, Monkey Do

Parents’ actions often speak louder than words. And, when children observe their parents repeating the same behavior frequently, they tend to copy. (Monkey see, monkey do.) A woman from Placentia, California emulated her mother’s repetitive criminal behavior and followed her lead right into a...

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.

X-rated Rx

The Rx symbol is found on doctor’s prescription pads, as well as on signs in pharmacies. (Here’s your medical lesson for the day: Rx is derived from the Latin word “recipe,” which means “take”.) A Mount Holly, North Carolina physician was definitely “on the...

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