Saturday, April 17, 2021

Follow the Rules!

It’s not uncommon for healthcare providers to get caught not following healthcare laws regulating prescription medications and billing to Medicaid and Medicare. And when they do, the penalties are often steep. An Ashland, K.Y., physician learned this the hard way after settling civil claims...

Protecting the Public Purse

You might be surprised what people will do to keep collecting a monthly check from the federal government. One common way that people steal benefits they don’t deserve is by failing to report the death of a loved one to the Social Security Administration...

Diagnostic Fraud

Diagnostic tests are necessary to determine how to correctly treat medical symptoms and conditions. A California man used his diagnostic testing clinics to carry out a scheme that bilked nearly $7 million from Medicare by ordering unnecessary tests for patients he illegally recruited. (The...

Smoke and Mirrors

Magicians have been known to use ''smoke and mirrors'' to create a distraction that leads their audience to believe magic has occurred. Fraudsters often use money laundering to create a similar effect by moving illegal proceeds between shell companies, which appear to be legitimate....

You’re Gonna Pay

Payroll taxes are the focus in today’s “Fraud of the Day.” Employees usually pay their share via paycheck deductions and then employers pay the Internal Revenue Service (IRS) an amount based upon the employee’s wages. Today’s fraudster collected his employees’ payroll taxes, but neglected...

Doctor Takes His Cut

Medicare can cover in-home health care services when patients are confined to their homes due to illness or injury. The goal is to provide medical care that is just as effective but more convenient and ideally less expensive than hospital care. Not so when...

A Dime A Dozen

It seems that retailers who abuse the Food and Nutrition Service’s (FNS) Supplemental Nutrition Assistance Program (SNAP) are a dime a dozen. The U.S. Department of Agriculture reports that approximately 35,891 food retailers illegally trafficked more than $1 billion in SNAP benefits between 2012...

Medicare Menaces

A health care provider's dedication to good care—guiding the patient toward the right service vs. the wrong one—can sometimes mean life or death (especially when the patient is elderly). So it's particularly troubling to hear of health care workers who actively blurred these lines...

Walking a Fine, Wavy Line

For a Carl Junction, Missouri pharmacist, there’s a fine, wavy line between legally and illegally filling prescriptions. Today’s fraudster committed healthcare fraud by signing for auto-refill prescriptions that were intended for his pharmacy’s clients and billing Medicare, Medicaid and Tricare for refills that were...

Quick Study

While the Department of Education distributes around $150 billion in student financial aid on an annual basis, tens of millions of dollars go to fraudsters who apply for student aid using stolen identities. (To say that is a lot of money is an understatement.) A Danville,...
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