Tuesday, November 29, 2022

Privilege vs. Right

It is a privilege to be a healthcare professional in the Medicare program, not a right. When an excluded health care provider blatantly disregards restrictions and bills federal health care programs anyway, they lose their right to participate as a provider. That’s exactly what...

Sweet Home Alabama

Medicaid is a state-run insurance program intended to help individuals and families afford health insurance when they may not otherwise be able to. The Medicaid program is also seen as a lucrative target for fraudsters looking to defraud government programs for their own benefit. An...

Counseling Crisis

Medicaid recipients are some of the most vulnerable among us. Things are even worse for those needing mental healthcare, which is one of the toughest specialties for accessing treatment. In the world of fraud, it’s especially appalling when a practitioner would breach the trust...

No Services Needed

Psychologists are supposed to help those who are struggling by providing counselling. Unfortunately, some healthcare companies and professionals choose to betray the trust of their clients and use their position to commit Medicaid fraud. (Which ironically causes the need for those defrauded to require...

Did Someone Run That Metrics Report?

One purpose of running a Regional Sales Reports is to enable clear and real-time analysis that compares store performance against other stores. If a report was ever run for stores authorized to accept SNAP benefits for Jefferson County in Alabama, for 2014 to 2017,...

The Make It Fraud Company

Jason Carl Pears was having a difficult time during the pandemic, according to his lawyer in Southern District of Alabama federal court on August 26th.  But it was no excuse for concocting not one but two schemes to steal more than $1 million from...

Breaking the Cycle

The goal of the Supplemental Nutrition Assistance Program (SNAP) is to alleviate hunger and malnutrition by providing monthly benefits to eligible low-income families through electronic benefit transfer (EBT) cards. An article posted on AL.com tells the story of how a few shoplifted steaks started...

Doubly Unqualified

The State of Alabama 's Medicaid agency requires mental health counselors to meet specific licensure requirements before providing services to underprivileged patients and submitting claims for reimbursement. The owner of an Alabama counseling business was doubly unqualified to participate in the Medicaid program for...

How Not to Become a Millionaire

There is a wealth of information available on how to become a millionaire. Books, magazines and financial blogs abound with great advice, such as: earn more than you spend; save a set percentage of your income each month; or, make regular investments in the...

Stuck on Fraud

Listen to this Story Many consider the Deepwater Horizon/BP oil spill to be the largest disaster in the history of petroleum. When the environmental catastrophe occurred in the Gulf of Mexico in April 2010, the explosion and collapse of...
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