Wednesday, March 3, 2021
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Healthcare Fraud

Bound for Bankruptcy

Owning a successful business on paper does not always equate to successfully operating one. This is especially true for business owners whose best practices include participating in illegal financial schemes and defrauding the U.S. government. Mississippi businessman Wade Walters pleaded guilty to participating in a...

Dirty Dozen

The purpose of a medical research study is to use human participants to add to the body of medical knowledge. (Medical research studies are used to test the efficacy and safety of new interventions and often lead to medical breakthroughs and even cures.) Today,...

Compounding Problems

Compounding interest is every investor’s friend. Over time, interest is earned on the principal amount deposited, plus the accumulated interest from previous periods. (Before you know it, even a small amount of money invested at a consistent rate can turn into a fortune.) A...

Compounding Problems

Pharmaceutical sales can be a rewarding and lucrative career field. But when the desire for profits trumps following the law, sales reps can go to jail. A 45-year-old Camden, N.J., man is facing 20 years in prison after pleading guilty to one count each of...

Putting Fraud to Bed

According to the American Sleep Association (ASA), between 50 and 70 million adults in the U.S. have a sleep disorder. The former owner of multiple sleep study clinics in Maryland and Northern Virginia capitalized on those statistics by causing a loss of more than...

Compounding Ill-Gotten Gains

Compounded medications are custom mixed for individual patients, and often carry a correspondingly high price tag. That evidently makes them temping fodder for healthcare fraud. Three Oklahoma marketers decided that potential profits merited hefty physician kickbacks in a prescription fraud scheme. (It appears their...

The Opioid Crisis: When Healthcare Fraud Turns Deadly

The Opioid Crisis is now a Public Health Emergency. Combating the crisis and the criminals using fraud to perpetrate it (and often using taxpayer-funded dollars to do so), is critical. It is going to take data from multiple sources – providers, medical claims, pharmacy claims, public records, law enforcement records management system, computer-aided dispatch and more – to win. Siloed data will be the enemy of success, but data sharing will enable success.

Sticky Situation

Acupuncture, which was developed more than a thousand years ago in China, is an alternative medical practice that uses needles to alleviate pain and nausea or treat chronic health conditions. (For those who do not like needles, physical therapy and chiropractic treatment can also provide...

Bogus Bonuses

Workplace performance bonuses are a great thing, unless they are driven by incentives that can send you to jail. That is the case for a pair of Texas women who were convicted recently on six counts of healthcare fraud that involved overbilling the federal...

The Doctor Will See You Now

Doctor visits are expensive in terms of time and money. It’s not uncommon to arrive on time for an appointment, then be kept waiting for what seems like forever to only get a few minutes with a physician. According to a survey on how...

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