Thursday, December 1, 2022

Modus Operandi

Fraudsters consider lying to be an important part of their modus operandi. (It's just part of the job description.) A Federal Bureau of Investigation (FBI) press release tells about a Louisiana doctor who scammed Medicare out of millions of dollars by lying about the...

Terminal Fraudster

The former head of Novus and Optimum Health Services has pleaded guilty to conspiracy to commit healthcare fraud and healthcare fraud. Bradley J. Harris, 39, admitted in court to using his hospice business to defraud Medicare and Medicaid out tens of millions of dollars. Harris...

Stop the Bleeding in Health Insurance Exchange Fraud

The Affordable Care Act (ACA) has provided millions of Americans an opportunity to get health insurance and has generated positive benefits for insurers, as well. However, the way that people now purchase health care plans – through online health care exchanges – has opened...

Short-Sighted

A person who is short-sighted doesn’t have much foresight into what might happen in any given situation. (You could say they are living in the moment without much regard to the future.) The owner of an eye clinic in Jasper, Georgia was short-sighted when...

To Dispense or Not to Dispense

Mohamad Ali Makki, 46, of Dearborn Heights, Mich., participated in a healthcare fraud scheme that defrauded Medicare, Medicaid, and Blue Cross Blue Shield of Michigan of nearly $10 million. As a licensed pharmacist at LifeCare Pharmacy in Farmington Hills over six years, Makki and...

Fatal Fraud

Fraud is generally not considered fatal, just costly (and really aggravating) for victims. In fact, criminals, who may have previously committed crimes such as selling drugs, often turn to fraud because they can make a good amount of money without as much risk. Today,...

Hypocrite

Depending on the labor and ingredients required, costs for compounded medications can be quite expensive. A Georgia podiatrist committed healthcare fraud by participating in a kickback scheme that generated patients who supposedly needed compounded medications. He collaborated with a pharmacy, who billed the unnecessary...

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 Placebo Effect

Topical anti-inflammatory creams are one of the best ways to safely reduce inflammation and pain in muscles and joints. (That’s assuming the anti-inflammation drug is actually included in the cream.) A Fayetteville, North Carolina pharmacist committed healthcare fraud by billing both Medicare and Medicaid...

Betting Your Bottom Dollar

An estimated 140 million people across the United States collect coins. Some people take up the hobby because they appreciate the rarity and beauty of some coins and enjoy the challenge of finding that “perfect” coin. Others like to learn about the history, politics,...

Get Your Fraud Fix!

Five days a week wake up to the most current fraud article in your mailbox.