Medicare Fraud

Every year, we lose billions of dollars to fraud in federal and state health care programs. Every dollar we lose to fraud and abuse is a dollar that is not available to provide home care to seniors, to treat HIV and AIDS, to immunize children, and to discover new treatments for cancer and other diseases. Some fraud schemes even pose a direct threat to the health and safety of patients. Many instances of health care fraud sug­gest that existing control systems do not work the way we imagine they should. Often the manner in which schemes are revealed suggests detection is more luck than system. Whistleblower lawsuits have exposed billing by health care providers for services not rendered, billing for products not delivered, misrepresenting services, unbundling services, billing for medically unnecessary services, duplicate billing, increasing units of service which are subject to a payment rate, falsifying cost reports resulting in increased payment to the health care provider, kickbacks, and on and on. Healthcare fraud is still going strong and this blog is intended to keep readers up to date with all healthcare fraud related news and to provide commentary when warranted. This blog also contains an array of laws and regulations concerning healthcare fraud set out in an easy to read format.

From the monthly archives:

January 2008

Government Cracks Down on Violators as Medicare Fraud Increases

by Nolan and Auerbach on January 10, 2008

The federal government is about to announce a national effort to fight Medicare fraud by looking at billing by medical equipment suppliers. There has been an increase in Medicare fraud, particularly in Southern California and South Florida where Medicare are plenty. The crackdown is a nationwide effort by the U.S. Department of Health and Human [...]

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HealthSouth and Its Doctors Pay Nearly $15 Million Settlement to Government

by Nolan and Auerbach on January 2, 2008

HealthSouth is the nation’s largest provider of inpatient rehab services and was formerly one of the largest providers of outpatient rehab services, ambulatory surgery services and diagnostic imaging services until it sold those businesses earlier this year.  However, illegal Kickbacks and False Claims have cost HealthSouth Corporation and two of its physicians nearly $15 million.  [...]

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