Medicare Fraud News, Breaking Headlines and Insight from the Qui Tam Perspective
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On April 22, 2009, New York Medicaid Inspector General James Sheehan testified before the U.S. Senate Committee on Homeland Security and Governmental Affairs Subcommittee on Medicare and Medicaid about waste and fraud. New York was the most successful state in the nation in Medicaid program integrity in the past year, measured by fraud and abuse [...]
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Medicare spending on home health was $12.9 billion in 2006—that’s up 44% since 2002, according to Government Accountability Office (GAO) report released March 13, 2009. Upcoding, by home health agencies, as well as other fraudulent and abusive practices, such as kickbacks and billing for services not rendered, contributed to the rise in Medicare spending for [...]
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The Centers for Medicare and Medicaid Services (CMS) paid about $4.4 million to Medicare Advantage plans on behalf of enrollees, after those enrollees had died. CMS made the improper payments for 2,657 deceased enrollees between January 2003 and April 2007, according to the March 2009 report “Review of Medicare Payments to Managed Care Plans on [...]
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A federal monitor’s report found that the University of Medicine and Dentistry of New Jersey made since 2002, $5.7 million in illegal payments to physicians in exchange for their heart patient referrals. As the result of these patient referrals, physicians were given “no-show” teaching jobs in excess of $150,000 per year. The monitoring system was [...]
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