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Dental Fraud Schemes Uncovered

Compliancy Group

This month, fraud in the medical industry has been making headlines fairly frequently. In one case, the dentist himself was involved, practicing on a revoked license. We also covered two Medicaid fraud schemes , one resulting in billions of dollars in billing for medical supplies that were never received.

Fraud 52
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Preventing Unlicensed Individuals and Subsequent Fraudulent Claims Submission

Provider Trust

On June 7, 2022, Theresa Pickering of Norcross, Georgia was indicted by a federal grand jury on federal charges of health care fraud, aggravated identity theft, and distribution of controlled substances. In addition to these allegations of fraud, waste, and abuse, Pickering had a history of fraud. According to the U.S.

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Two NY Home Healthcare Agencies Settle False Claims Act Allegations for $5.4 Million 

Healthcare Compliance Blog

The New York Wage Parity Act, Public Health Law sets minimum wage and benefit requirements for licensed home care services agencies (LHCSAs) that employ home care aides who render services to Medicaid recipients in New York City and three counties in New York. million to New York State for conduct between 2014–2017.

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CMS Issues Contract Year 2023 Final Rule for Medicare Advantage Organizations and Prescription Drug Sponsors

Healthcare Law Blog

At the beginning of the applicable contract year, the credit and the use of LOIs will no longer apply and, if the application is approved, the MAO must be in full compliance with network adequacy, including having signed provider and facility contracts. A warning letter = 3 points. A notice of noncompliance = 1 point.