Monday, September 20, 2021

The Bottom Line

The term “bottom line” generally refers to the last line of a financial statement that reveals whether an organization is making a profit or loss. It can also describe the most important thing that should be considered. The bottom line of today’s fraud article...

No Show’ Means ‘No Go’

A lot of health care fraud is committed by medical providers who claim they performed procedures on patients, when in reality they did not. (It's one of the oldest tricks in the fraud book.) They fraudulently bill government insurance programs for the bogus care,...

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...

Go Big or Go Home

Most of the workers’ compensation fraud stories covered on FraudOfTheDay.com tend to involve small to medium-sized businesses who try to defraud state workers’ compensation programs or private insurers by underreporting payroll to avoid high insurance premiums. (Or they simply don’t provide workers’ compensation insurance...

Footing the Fraud Bill

Podiatrists have a complicated and sometimes unpleasant job when it comes to the diagnosis and treatment of more than 26 bones, over 100 muscles, tendons and ligaments and 33 joints in the foot. A podiatrist in Pennsylvania used his patients to take a load...

Beware of Rising Premiums

A Washington, D.C.-based insurance broker was in a good position to get rich off one of the U.S.’s biggest health insurance companies. That is, until the law caught up with him. Now, he’s facing prison time for healthcare fraud and identity theft. A federal jury...

Loud and Clear

The False Claims Act (FCA) came about in 1863 when Congress became concerned that suppliers serving the Union Army during the Civil War were defrauding the Army. At that time, the FCA required any person who knowingly submitted false claims to the government to pay $2,000...

Fraud Care Plan

Health care professionals rely on individualized care plans to successfully treat patients. (These plans can provide details on medical or home health care treatment recommendations and prescriptions.) Medical certificates are issued by physicians or health care providers to provide evidence of a health condition....

Minimize

For some people, living a minimalist lifestyle means having a happier life. This is not so for the owner of a pharmacy in Red Bud, Illinois and his wife. After the pharmacist was charged with healthcare fraud, his wife tried to minimize their connection with the...

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...

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