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.

OIG says it will make Recoveries of almost $3 Billion for HHS Programs in First Half of FY 2007

by Nolan and Auerbach on June 15, 2007

The Department of Health and Human Services Office of Inspector General Semiannual Report to Congress reports that the OIG will recover nearly $3 billion for Medicare fraud reports that the OIG will recover nearly $3 billion for , Medicaid fraud , and other healthcare federally-funded programs for the first half of fiscal year 2007. The recoveries are the result of OIG audits ($1.5 billion) and investigations ($1.4 billion). The OIG says additional recoveries to states and other federal agencies result from investigations with which it was involved between Oct. 1, 2006, and March 31, 2007.

The report is available here.

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