Monday, August 19, 2019

Feeding Fraud

If a patient is unable to consume food or liquids by mouth, doctors may prescribe a feeding tube that can be put directly into the stomach through the abdomen. This procedure bypasses the mouth and esophagus and goes directly into the intestinal system,...

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...

If the Shoe Fits, Wear It

If a shoe doesn't fit, you wouldn't want to wear it. (No one likes to wear shoes that hurt their feet.) Similarly, for people who wear prosthetics, a custom fit is a necessity. An article published by the St. Louis Post-Dispatch follows the story...

From Exclusive to Excluded

There are many benefits to joining a club. Club membership can open up new avenues for meeting new people, learning new skills, and advancing careers. Today, we learn about a woman from Mount Pleasant, South Carolina who was a member of the “Fraudster Club”...

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...

Addicted to Fraud

Drug and alcohol abuse can harm a person's health and personal relationships, and interfere with his/her ability to work. An article posted on InsuranceNewsNet.com tells about a pharmacy owner who became addicted to prescription drugs and alcohol, and turned to fraud to finance...

What a Pain

Today’s “Fraud of the Day” is based on an article entitled, “Daphne pain doctor pleads guilty to healthcare fraud, money laundering,” posted on AL.com. A former pain doctor, who operated in Baldwin County, pleaded guilty to federal charges for defrauding Medicaid.

An Earful at the State Fair Leads to Massive Fraud

It's always unfortunate to hear about crimes committed by those paid to uphold the law. The Citizen reports that a New York state corrections officer was paid nearly $75,000 by a hearing aid provider, for help defrauding the state medical insurance plan. After a chance...

Faking It Didn’t Make It

There is no cure for Sickle Cell Anemia, an inherited condition where there are not enough healthy red blood cells to carry adequate oxygen throughout the body. (Some of the symptoms of Sickle Cell Anemia include swollen hands and feet, fatigue, or jaundice of...

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.

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