Wednesday, March 3, 2021

Let’s Be Reasonable

An Iowa ear, nose, and throat doctor facing allegations of false Medicaid claims for endoscopic sinus surgeries contends that “reasonable people can disagree about the best medical options.” (But how reasonable it is to disagree on 115 medical procedures from one physician in one...

At Others’ Expense

Non-emergency medical transportation (NEMT) plays a big role in keeping millions of Americans healthy. Without this vital service, many patients would not be able to receive a ride to their medical providers for care. A couple who operated a transportation company out of Binghamton,...

Jamaican Me Crazy

Fraudsters love to spend their stolen money on lavish lifestyles, expensive vehicles, luxurious designer items and trips to warm climates ,preferably islands where they cannot be easily found. A former mental health counselor from Pennsylvania used Medicaid to fund at least 24 trips out...

Fraud is Calling

If you have watched TV within the past couple years, you have likely heard the popular cell phone commercials that feature the question? ''Can you hear me, now?'? While the advertising goal is to point out that one service provider is able to deliver...

Fraud is a Huge Gamble

Six home healthcare workers and patients were charged with making false statements to Medicaid regarding home healthcare services that were neither received nor provided. All of the Indictments involve allegations that the defendants made false statements in Medicaid timesheets that certain patients and workers provided or received personal care services when, in reality, the patients or workers were actually somewhere else.

Power

Sometimes power changes people for the better and sometimes it doesn’t. Some people use a position of power to help others around them, while others use it to serve themselves. A former Nebraska Medicaid administrator used his position as power of attorney for his father to...

Everything Has a Price

Everyone dreams of living a lavish lifestyle at one time or another. Who hasn't imagined lounging on the sandy beach of a remote island resort, driving a brand new luxury vehicle or wearing an expensive piece of jewelry that defines the word ''bling?'? Billboards,...

Seems Like Forever

Criminals must be overly optimistic about their ability to carry out a fraudulent scheme, otherwise they wouldn’t be so bold in their attempts to commit crimes. However, if they would just stop for a moment and consider the consequences of their actions, there would...

Hovering Dentist Faces Jail Time

It’s a trademark of digital natives to overshare information and images. They’re young enough to have not known a time before people instantly shared video and images of everything from what they had for breakfast to bathroom selfies. (Too much information if you ask...

No Free Rides

Medicaid pays for non-emergency ambulance transportation costs as long as a doctor provides a statement justifying the need for the service. (Medicaid beneficiaries are eligible for this service if they don't have a working vehicle or a driver's license; have a mental or physical...

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