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Health Care Investigations Archives

NY man sentenced to 3 years, $10 mil for health care fraud

A New York man recently agreed to a plea deal with the government for allegations of health care fraud. According to his plea agreement, the accused requested blank prescriptions from a physician friend. The accused then put in the names of other patients and made copies of the prescriptions to help perpetrate a fraudulent scheme.

Medicare Fraud Strike Force arrests 5 New Yorkers

The Medicare Fraud Strike Force recently announced the arrest of five New Yorkers based on charges of health care fraud. The arrests were part of a larger coordinated health care fraud enforcement action that led to the arrest of 48 individuals throughout the Northeast in connection to a scheme involving over $800 million in false and fraudulent claims.

Want to run a successful diagnostic lab? These 2 tips can help.

Patients who seek services in the health care industry are starting to expect clarity from their providers. Whether seeking a dental cleaning, cancer screening or blood test, patients are more regularly asking about the service they will receive and the likely cost. Diagnostic and reference labs can make the most of this new trend in patient care with the following tips:

NY ambulance company owners take plea deal in fraud case

The Medicare Fraud Strike Force (MFSF) recently concluded an investigation of a New York based ambulatory company. The MFSF is part of a joint initiative between the Department of Justice (DOJ) and the United States Department of Health and Human Services (HHS) tasked with deterring fraud and enforcing applicable laws.

3 lessons after health care exec gets 20 for health care fraud

A United States district judge recently sentenced a health care executive after the government accused him of running an elaborate network that benefited from the use of illegal referrals. According to the indictment, the accused owned and operated skilled nursing facilities and assisted living facilities. The government accused the businessman of using illegal bribes and kickbacks to encourage medical professionals to recommend the use of his businesses to patients.

DOJ charges 30 in "patients for cash" health care fraud scheme

The Department of Justice (DOJ) recently charged 30 in a "patients for cash" health care fraud scheme. According to the indictment, a home health organization illegally paid doctors, nurses, and at least one social worker along with other medical professionals in violation of the Anti-Kickback Statute (AKS) for referral of patients to a home health organization.

CMS announces increased health care fraud enforcement measures

The United States Centers for Medicare and Medicaid Services (CMS) recently announced a new rule to address health care fraud. The announcement was made in September 2019. The new rule expands the agency’s ability to revoke or deny applications for entry or re-enrollment into the Medicare, Medicaid and CHIP payment programs.

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