The U.S. government annually loses billions of dollars to Medicare fraud. It is the type of crime committed by people you know, including doctors, nurses, pharmacists and medical staff who provide services and medications that patients do not need and then pocket the...
Healthcare is an extremely regulated industry. Programs like Medicaid and Medicare face tough scrutiny from regulators intent on stopping abuse and fraud. Organizations found guilty of fraudulent activity face harsh penalties, even though the regulations and laws in...
Over the past two decades, the U.S. has tried to curb fraudulent health care provider Medicare claims through greater oversight. Prepayment audits are one method that the government has begun using to prevent reimbursement for faulty claims. Unfortunately, if...
Revocation of Medicare and Medicaid contracts can significantly damage your practice and affect your ability to operate in your field. It is crucial to understand your appeal rights to avoid the potential issues that can result from revocation. The initial steps of a...
As a health care provider accepting Medicaid, there are times you may have received an overpayment. It is a common issue that you can remedy with a refund. However, missing an overpayment and not correcting the mistake may lead to the government subjecting you to a...
Attorneys for a Texas physician convicted in January in a $325 million health care fraud scheme requested this month for an earlier sentencing date for Dr. Jorge Zamora-Quezada. A jury found the disgraced physician guilty of seven counts of health care fraud and one...
Our nation’s health care system has grown more complicated. And with these complexities come increased chances for illegal and negligent activity within health care organizations. With this in mind, health care providers must take it upon themselves to prevent...
In a Medicaid fraud case that has lasted for more than a decade, disgraced Dallas dentist Richard Malouf must pay Texas an estimated $12 million. In a major government rip-off, Malouf fraudulently billed Medicaid for dental services that were provided by another...
Health care professionals have always been in high demand, but even more so during the current COVID-19 pandemic that has gripped the world. But even in times like these, some doctors and nurses face disciplinary actions that could lead to professional sanctions,...
A Massachusetts hospital recently settled a federal lawsuit over allegations that it billed Medicare and Medicaid for medically unnecessary tests.But to many, tests like these may seem easy to order accidentally or without knowing they could be medically unnecessary....
