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.

Dr. Comfort Shoes in an $18 Million Tight Squeeze

by Nolan and Auerbach on October 10, 2006

Dr. Comfort Shoes (also known as Rikco International LLC) cannot be feeling too comfortable these days. In March of this year, FBI agents executed a search warrant which was unsealed this week, alleging the company located in Mequon, Wisconsin, cheated Medicare of millions of dollars by claiming diabetic shoes and inserts were approved by Medicare for reimbursement when in fact they were not.

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