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Progressive lawmakers call on CMS to cull companies with history of Medicare fraud from ACO REACH

Healthcare Dive

At least 10 organizations with records of healthcare fraud and abuse prior to 2021 participated in the direct contracting program last year despite CMS screening requirements, the letter said.

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Healthcare Fraud and Abuse Control Program Fiscal Year 2021 Report

Med-Net Compliance

The report says that in FY 2021 the DOJ opened 831 new criminal healthcare fraud investigations. Federal prosecutors filed criminal charges in 462 cases involving 741 defendants, and a total of 312 defendants were convicted of healthcare fraud related crimes during the year. You can view the report here: [link].

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DOJ recovers over $5B in healthcare fraud settlements, judgments in 2021

Fierce Healthcare

DOJ recovers over $5B in healthcare fraud settlements, judgments in 2021. Wed, 02/02/2022 - 12:13.

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Understanding the Medicaid Fraud Control Unit’s 2023 Annual Report

Provider Trust

This year, as always, the Medicaid Fraud Control Units (MFCUs) released an annual report dissecting the exclusions, enforcements, and overall takeaways from their work throughout the previous fiscal year (FY). This year’s report also shows greater participation from managed care organizations (MCOs) as a key trend.

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Massachusetts Medicaid Fraud Division Recovers Over $55 Million in 2021

Healthcare Compliance Blog

On January 19, 2022, the Massachusetts Medicaid Fraud Division announced that in calendar year 2021, more than $55 million was recovered from individuals and entities who defrauded the state. The Attorney General’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state Medicaid program, MassHealth.

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18 Former NBA Players Indicted For Alleged $4 Million Health Care Fraud Scheme

The Health Law Firm Blog

Board Certified by The Florida Bar in Health Law On October 7, 2021, 18 former NBA players were charged in New York federal court for an alleged health insurance fraud scheme to rip off the league's benefit plan, according to an indictment filed in the Southern District [.] By George F. Indest III, J.D.,

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Orthopedic surgeon arrested in $10 million telehealth fraud case

Healthcare IT News - Telehealth

Attorney's Office for the Eastern District of New York announced Thursday that an orthopedic surgeon had been arrested and charged with healthcare fraud. Federal law enforcement has brought the hammer down on alleged telehealth fraud in several highly publicized cases. " ON THE RECORD.

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