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.

Posts tagged as:

Medical equipment

Homecare Association Presents 13-point Plan to Eliminate Medicare Waste, Fraud and Abuse

by Nolan and Auerbach on May 7, 2009

In April 2009, the American Association for Homecare presented Congress with its 13-point legislative action plan, called the Medicare Anti-Fraud Legislative Plan, aimed at eliminating waste, fraud and abuse in Medicare’s home medical equipment sector. The plan’s steps, according to the homecare association, would eliminate most of the Medicare fraud attributed to the home medical [...]

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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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Pilot Program Targets Durable Medical Equipment Suppliers

by Nolan and Auerbach on August 29, 2007

The federal government has instituted a two-year pilot program, in Florida and California, targeting medical equipment suppliers in to root out those who defraud Medicare, by requiring them to reapply to the program. As the result of this program, sellers of durable medical equipment such as providers of artificial limbs, braces, splints and wheelchairs need [...]

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South Florida Medicare Fraud Causes Government to Take A Closer Look

by Nolan and Auerbach on June 4, 2007

Federal officials have documented in excess of $140 million in Medicare fraud in South Florida alone.  With 38 arrests in a recent sting operation, the government has said it will take a closer look at other providers of medical equipment.  Health and Human Services Mike Leavitt has said that increased enforcement efforts nationally could save [...]

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Scooter Store Gets Caught Scooting Medicare

by Nolan and Auerbach on May 25, 2007

In order to settle allegations that the Scooter Store submitted false claims to Medicare, the New Braunfels, Texas company agreed to pay the federal government $4 million and forego another $13 million in Medicare payments. The payments resolve several lawsuits including a whistleblower complaint from a former Scooter Store employee.  The whistleblower will receive $3.2 [...]

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