Monday, March 8, 2021

Defining Necessary

Healthcare.gov defines “medically necessary” as “health care services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medicine.” A Nigerian man received a Medicare fraud conviction because he paid kickbacks for fraudulent...

Feeding and Starving Addictions

Addictions to things such as drugs, gambling, gaming, food and shopping can be costly in terms of losing money, family or friends. (As opposed to binge-watching, which tends to waste time but at least it’s entertaining, and you can do it with your family...

Sinking Ship

There is a maritime tradition that involves the captain going down with the ship. In other words, he is responsible for saving his crew, or he will risk his life in the process. The former owner and medical director of a Baton Rouge, Louisiana...

Good Friends

In today’s “Fraud of the Day” article, we take a look at a patient recruiter from South Florida who referred Medicare beneficiaries to a now defunct home health care agency, Good Friends Services. As you might guess, the patient recruiter and the home health agency...

No Drugs Dispensed

A federal jury in Los Angeles, California found a pharmacy owner guilty for her role in a Medicare fraud scheme involving more than $1.3 million in fraudulent claims for prescription drugs.  Tamar Tatarian, 39, a Pasadena pharmacy owner, was sentenced to...

Three Times a Charm

A woman in Medford, Mass., admitted to lying so she could receive $108,288 in Social Security, Medicare and MassHealth benefits and food stamps over a 10-year period. (SO ambitious!). She was subsequently charged for her Food Stamp, Social Security and Medicare fraud scheme (Three...

Watch Out for DNA Scams

It appears that a new wave of Medicare fraud scams involving DNA testing has been detected. Whether lured by free ice cream or scared of potential life-threatening illnesses, senior citizens are being deceptively convinced to provide their Medicare number in exchange for a cheek swab....

Fraud is Painful

Pain clinics typically provide solutions for unmanageable pain caused by conditions such as arthritis, back pain, cancer, migraines and neck pain just to name a few. (When an over-the-counter remedy doesn’t work, these are the people to contact.) Two pain management doctors in the New...

Paper Pushers

Paper pushers are usually associated with doing boring or unimportant work. Today, we take a look at two Houston-based physicians who took paper pushing to a whole new level in totally separate multimillion-dollar Medicare fraud schemes. They signed off on fraudulent paperwork that caused the government healthcare...

Ripe for the Picking

Florida is known for a lot of fun things including Disney World, the Space Coast, SeaWorld and Miami Beach. Unfortunately, South Florida is not only known for humidity and alligators, it’s also the nation’s capital of healthcare fraud. The incidence of healthcare fraud is so bad...

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