Sunday, January 24, 2021

Pinky Promise

When Medicaid providers accept new patients, they essentially make a promise to provide good care and to protect their healthcare records and personally identifiable information. While the operators of two businesses in Bridgeport, Connecticut that offered social and psychotherapy services to their patients appeared...

Blatant Disregard

Sometimes welfare recipients unintentionally make mistakes on their applications for government benefits. Today’s fraudster, a York, Pennsylvania man, intentionally lied on multiple applications for Medicaid and Supplemental Nutrition Assistance Program benefits. He committed Medicaid fraud and SNAP fraud when he blatantly disregarded the government’s rules. Read on...

Oh Behave

According to Medicaid.gov, the government benefits program is the single largest payer for mental health services for adults and children in the United States. The owner of an Oklahoma-based behavioral health counseling service and her son, who was employed by the business, took advantage...

Putting a Stop to Fraud

More than 2.1 million residents of North Carolina receive Medicaid benefits. (Just so you know, that’s about 20 percent of the state’s population.) The government healthcare program and taxpayers took a $900,000 hit when a Durham woman used her two mental health businesses to carry out...

Addicted to Fraud

Psychiatrists are supposed to help those in need of mental health services but some take advantage of their patients’ frail states rather than fulfill their professional duties. One psychiatrist from Pennsylvania admitted to orchestrating a “pay for prescription” Medicaid fraud scheme. Lancaster local Bassam El-Borno,...

Wrong Turn

Today’s “Fraud of the Day” is based on an article entitled, “NM man sentenced in almost $2MIL health care fraud,” published by Albuquerque Journal. A New Mexico man was sentenced in federal court in Albuquerque to 30 months in prison and ordered to pay $1,218,165 in restitution for his role in defrauding Arizona health care benefit of almost $2 million.

No Integrity

To maintain the integrity of MaineCare, Maine’s Medicaid program, regular audits are performed to protect against fraud, waste and abuse. The healthcare program uses referrals, complaints from other state agencies, healthcare providers or members, and data analysis to detect patterns or trends that may indicate fraudulent actions....

Major Fraud Against Minors

Kids in foster care are among our society's most vulnerable and deal with untold loss. Sadly, they also are among our most targeted for fraud, as is the case in today's Fraud of the Day. The story, reported in the Elko Daily Free Press,...

That’s the Way the Ball Bounces

In the state of Oklahoma, Medicaid pays for behavioral health rehabilitation services that are designed to support and treat children and their families who are experiencing difficulties in their daily lives. The intent is to help them improve their lives through counseling by keeping...

Taken on a Ride

Medicaid covers eligible beneficiaries who need a ride to a doctor’s appointment, hospital or other medical office. (Obviously, the destination must be an approved provider and drivers are only supposed to transport patients to the medical appointment then back home, with no unnecessary stops in between.)...

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