Wednesday, January 23, 2019

Living Large

Twitter is one of the fastest growing ways that people communicate. It is considered a micro-social media platform due to its 160 character limit, but it can provide macro benefits in investigations for law enforcement. In my experience,...

Restraining Fraud

Home health care is necessary for many patients being discharged from hospitals. Just to name a few benefits, it can help patients recover from surgery, obtain a treatment plan to manage diabetes, or receive physical or occupational therapy. (While the additional medical care provides...

Compounding Problems

A pharmacy owner in Decatur, Alabama recently compounded problems for his business when he devised a healthcare fraud scheme that stole from TRICARE, the U.S. Department of Defense’s military health system. The pharmacy owner used his business to bilk more than $10 million from the government health insurance program and military families who deserved the benefits.

There’s No Substitute for Hard Work

There are occasions when it's o.k. to have a substitute. For example, when a teacher is sick it is acceptable to bring in a substitute teacher to lead a class until the regular teacher can return. (But when emergency services are involved, you don't...

Hindsight is 20-20

It's usually easy to see the difference between doing something the wrong way vs. the right way after the fact. (That's called hindsight.) An article posted on TulsaWorld.com tells about an optometrist who knew the difference between right and wrong, but made a very...

Not Quite Right

If a doctor's practice, home health care company or medical supply company has to pay a recruiter to bring in patients, then you can be sure that something is not quite right. (You can almost bet that Medicare or Medicaid fraud is going on.)...

Examining the Examiners

Medical examinations are required for many reasons. Children need a medical evaluation before they can attend school; an immigrant needs one if they wish to obtain a visa or green card and, some employers won’t hire until you’ve been looked over by a qualified...

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...

Foot Fraud

To put oneself in the shoes of another is to understand the circumstances or experiences of someone else. (I would be extremely reluctant to put my feet in the shoes of a fraudster because I would not want to experience the life of a...

What’s in the Doctor’s Bag?

The government loses tens of billions of dollars annually from a variety of fraudulent healthcare schemes. Upcoding, arguably one of the most popular methods used to siphon off healthcare funds, was the scam of choice for a Warren County, Kentucky physician who was recently...

Get Your Fraud Fix!

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