Friday, January 22, 2021

Defining Necessary

Healthcare.gov defines “medically necessary” as “health care services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medicine.” A Nigerian man received a Medicare fraud conviction because he paid kickbacks for fraudulent...

A Jack of all Frauds

It's not easy being a jack of all trades. You could split wood in the morning, run an IT firm later that day and prepare a five course meal that evening. The same translates to fraud. Many fraudsters stick to just one type of...

Second-hand Fraud

It has been said that one man's trash is another man's treasure. (This makes sense when talking about flea markets, but not so much when considering unused prescriptions.) An article posted on TheIslandNow.com tells the story of a New York pharmacist who defrauded Medicare,...

Seeing Double

Eye charts are used to determine visual acuity. If you're having trouble making out the letters and numbers when viewed from a distance, your eye sight needs to be corrected. But as reported by the Palm Beach Post, a personal assistant who worked in...

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...

At Home with Fraud

To say that someone is "at home" with doing something means that they are comfortable with their actions. Today 's "Fraud of the Day" covers four New Orleans doctors and two others who worked for a home health care company. They were "at home"...

Dying to Defraud

Dr. Nathaniel Brown, 62, of Cleveland, Mississippi, was sentenced before United States District Judge Neal B. Biggers, Jr. in Oxford, Mississippi. Dr. Brown was sentenced to serve thirty-nine (39) months in federal prison followed by three (3) years supervised release and ordered to pay $1,941,254 in restitution to the Medicare program.

COVID Feature: No One Else to Blame

Today’s fraudster has no one to blame but himself if he is convicted of fraud. Carlos Belone, 37, of Coconut Creek, Florida is charged with wire and healthcare fraud along with making false statements to a financial institution. Belone, who owns R&S Pharmacy, allegedly...

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...

Electric-powered Fraud

Listen to this Story</strong? Electricity unquestionably catalyzed an economic revolution and improved the quality of life of billions of people. For today's fraudsters, electricity was the crucial component in their get-rich-quick conspiracy. The Long Beach Post reports that a married...

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