Tuesday, April 20, 2021

At Risk

There's no doubt that fraud puts the integrity of taxpayer-funded health care programs at risk. And when at-risk children are victimized in the process, you can bet that the government will not hesitate to go after those responsible for the crime. That's what happened...

Rx for Fraud

A 52-year-old Decatur, Georgia man was recently sentenced to prison for committing healthcare fraud. He defrauded TRICARE and other insurance companies out of more than $6.5 million by using a Pensacola, Florida pharmacy to fill fraudulent prescriptions. While many instances of prescription fraud involve...

Home is Where the Health Care Fraud Is

In-home doctor visits are beneficial for housebound Medicare recipients. (House calls also are an easy way for unscrupulous doctors to illegally bill for services that were not performed or medically necessary.) An article published by The Detroit News states that a Michigan doctor used...

Compounding the Problem

Reimbursement rates for compounded drug prescriptions are high because a lot of work goes into combining and mixing the ingredients of a medication that is made specifically for a patient’s particular needs. These high reimbursement rates are a huge incentive for fraudsters to scam...

The Power of Persuasion

We are impacted by persuasion every day. Just turn on the television and within a few minutes, you’ve watched at least one commercial, if not more, advertising a sizeable discount if you call a toll-free number, log-on to a website, or run on down...

Say It Isn’t So

Speech therapists diagnose and treat patients that have communication and swallowing disorders resulting from strokes, brain injuries, hearing loss, developmental delays or other problems. Their job is to create and implement a treatment plan that will improve the patient's quality of life. An article...

Every Minute Counts

Every minute counts when it comes to submitting claims to government healthcare programs. A primary care doctor in Webster City, Iowa was quick to tally the minutes he spent with his patients at multiple nursing facilities (and multiply that number by seven). After nearly...

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...

Addicted to Fraud

Drug and alcohol abuse can harm a person's health and personal relationships, and interfere with his/her ability to work. An article posted on InsuranceNewsNet.com tells about a pharmacy owner who became addicted to prescription drugs and alcohol, and turned to fraud to finance...

Putting the Brakes on Fraud

There are a variety of ways to commit Medicare fraud including billing for unnecessary services or services not provided, up-coding or double-billing, or offering or accepting kickbacks, just to name a few. Today 's fraudsters, who were man and wife, tried a different tactic...

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