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:

Medicare Fraud

New Report Suggests Waste, Including Health Care Fraud, Is One Third the Health Care Budget

by Nolan and Auerbach on October 30, 2009

Keith Olbermann reported on MSNBC’s Countdown October 27 that President Obama has said that eliminating waste could pay for most of any health care reform package. But critics disagree. Those critics might be more than a little wrong. Olbermann says a new study suggests the President might have underestimated just how much waste there is. [...]

{ 0 comments }

President Obama Vows to Eliminate Healthcare Fraud and Reduce Waste

by Nolan and Auerbach on September 10, 2009

On Wednesday, September 9, 2009, President Barack Obama addressed Congress on the current debate over healthcare reform. In his speech, the President vowed he would eliminate “the hundreds of billions of dollars in waste and fraud.” Under his plan, an independent commission of doctors and medical experts would be appointed the task of uncovering fraud [...]

{ 0 comments }

Fighting Medicare Fraud

by Nolan and Auerbach on July 30, 2009

PBS business news correspondent Jeff Yastine interviewed Marcella Auerbach for his broadcast news segment titled, “Dozens Arrested For Medicare Fraud,” which aired nationally during the July 30, 2009 nightly news cast. Marcella was also quoted in Jeff’s related news article titled, “Fighting Medicare Fraud.” In celebration of the 44th anniversary of Medicare, the segment reported [...]

{ 0 comments }

Teaching Hospital Settles Physician Billing Case

by Nolan and Auerbach on July 16, 2009

In the July 13 edition of the Report on Medicare Compliance, Editor Nina Armstrong quoted Ken Nolan in her article titled, “Teaching Hospital Settles Physician Billing Case, Signs Second Agreement with OIG.” The article reported that Louisiana State University Health Sciences Center in Shreveport (LSUHSC-S) recently settled a dispute alleging it billed Medicare for surgery [...]

{ 1 comment }

Physicians Snared By Growing Medicare Fraud Strike Team

by admin on July 15, 2009

Marcella Auerbach was quoted by Amy Lynn Sorrel in her article “Physicians snared by growing Medicare fraud strike team,” which appeared in the July 6 online edition of American Medical News. The article discussed the announcement by the Department of Justice and Health & Human Services that criminal charges were filed against 53 doctors and [...]

{ 0 comments }

Double-billing Settlement Highlights Whistleblower Concerns

by Nolan and Auerbach on June 23, 2009

Earlier this week, the University of Medicine and Dentistry of New Jersey agreed to pay the federal government $2 million to settle a whistleblower lawsuit alleging that it bilked Medicaid in a double-billing scheme that started in 1993 and ended in 2003, according to the Department of Justice. The settlement was the second time UMDNJ [...]

{ 0 comments }

Alleged False Claims Act Violations Land Minnesota Hospitals in Hot Water

by Nolan and Auerbach on May 22, 2009

Three HealthEast Care System hospitals have agreed to pay the United States $2.28 million to settle allegations that the health care facilities submitted false claims to Medicare, the U.S. Justice Department announced May 21, 2009. According to the DOJ press release, the settlement resolves allegations that the St. Paul, Minn.-based hospitals overcharged Medicare from 2002 [...]

{ 0 comments }

Attorney General and HHS Secretary Announce New Interagency Health Care Fraud Prevention and Enforcement Action Team

by Nolan and Auerbach on May 21, 2009

The government has created a new interagency health care fraud prevention and enforcement team, according to a May 20, 2009 announcement by Attorney General Eric H. Holder, Jr. and Health and Human Services (HHS) Secretary Kathleen Sebelius. The new interagency effort, called the Health Care Fraud Prevention and Enforcement Action Team (HEAT), is charged with [...]

{ 0 comments }

Sheehan Calls for Aggressive Actions against Medicare, Medicaid Fraud and Abuse

by Nolan and Auerbach on April 23, 2009

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 [...]

{ 0 comments }

Houston Hospital to Pay U.S. More Than $9 Million for Alleged Medicare Fraud

by Nolan and Auerbach on March 27, 2009

Methodist Hospital in Houston has agreed to pay the United States $9.99 million to settle allegations that it defrauded the federal Medicare program, the U.S. Department of Justice announced March 26, 2009. The government alleged that, between January 2001 and August 2003, Methodist improperly inflated charges for inpatient and outpatient care to make its costs [...]

{ 0 comments }

← Previous Entries

Next Entries →