Monday, June 17, 2019

At a Higher Risk

Physical therapists are at a higher risk for malpractice claims due to the nature of their work. Some common reasons for malpractice suits include failure to properly supervise a patient, improper technique, injury from manipulation, burns from hot packs or stretching and exercise injuries....

Pill Mill Thrill

Fraudsters get a thrill out of stealing from others. Otherwise, they wouldn’t keep doing it. (The constant source of illegitimate income is also attractive.) A very deceptive Dover, Massachusetts physician got his thrill from running a multi-million-dollar Medicare fraud scam involving a pill mill. The...

Thorny Problem

Thorns are unpleasant. When one encounters a thorn, it tends to leave them wounded and often bleeding. Fraudsters are a lot like thorns. They are prickly, unpleasant and the primary reason why the Medicare program hemorrhaged an estimated $60 billion in 2017. (According to...

Quid Pro Quo

The Latin term “quid pro quo” translates into “something for something.” (In other words, it means, “if you scratch my back, I’ll scratch yours.”) A New Orleans, Louisiana woman committed Medicare fraud through a quid pro quo arrangement involving two Louisiana psychiatrists. While no...

The Worst of Intentions

During 2017, the federal government won or negotiated more than $2.4 billion in healthcare fraud judgements and settlements. (Of that amount $1.4 billion was returned to Medicare, while Medicaid received about $406.7 million.) The Medicare Strike Force, a joint initiative between the Department of...

The Heart of the Matter

The human heart pumps blood throughout the body, supplying oxygen and nutrients to tissues while removing carbon dioxide and other waste. (It is central to all body operations and without it, we cannot live.) Fraud operations are similar. Today’s spotlight shines on a cardiologist...

Bad Business Decisions

Bad business decisions can ruin a company. For instance, if your customers like the product or service you provide, don’t spend a lot of money trying to improve it. (Think of the New Coke vs. Old Coke saga back in the 1980s. If it...

Money Talks

When healthcare fraud occurs, kickbacks are often involved. (Medical kickbacks can include payment by cash, check, gift cards, luxury items, vacations, etc. in exchange for patient referrals, prescriptions or medical devices.) A Fontana, California woman, who owned and operated a La Verne-based home healthcare...

Getting the Boot

When someone “gets the boot,” it typically means that they get dismissed, or kicked out of a job or an establishment. A Bloomfield Hills, Michigan doctor could possibly “get the boot” from the podiatrist profession when sentenced for Medicare fraud. Ironically, because he unnecessarily...

Last Hurrah

The Social Security Death Master File (SSDMF) website explicitly mentions that access is restricted to only users who are certified. A Fort Pierce, Florida fraudster, who was definitely not qualified to have access, somehow tapped into the file that contains over 86 million personal...

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