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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.

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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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Big Bust Sweeps Out Medicare Fraud

The Health Law Firm

Board Certified by the Florida Bar in Health Law and Shelby Root The largest criminal health care fraud takedown in the history of the US Justice Department, in terms of both loss amount and arrests, took place June 18, 2015. Indest III, J.D.,

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Norton Healthcare Facing Class Action Lawsuit Over BlackCat Cyberattack

HIPAA Journal

The stolen information included names, addresses, email addresses, dates of birth, Social Security numbers, government identification ID numbers, driver’s license numbers, payment/financial institution information, health insurance providers, medical treatment information, medical diagnoses, medications, medical images, and lab test results.

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The History of Healthcare Compliance

MedTrainer

Licensing and credentialing were introduced to regulate healthcare professionals and ensure minimum standards of care. Compliance in healthcare began to encompass billing, fraud, and abuse prevention. Compliance evolved to include performance reporting and quality metrics.

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Is Your Medical Credentialing Taking Too Long?

Verisys

Primary source verification must be done to confirm a provider’s education, professional license and certifications, medical training, work history, references, and more. Provider information should be continuously monitored for any changes to exclusion or license status. However, verifying a provider’s credentials is essential.

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20 Years for Ohio Cardiologist Sentenced in $29 Million Overbilling Scheme

The Health Law Firm

Rendon, said of a Westlake, Ohio cardiologist sentenced to 20 years in prison on Friday, December 18, 2015, "This defendant used his medical license as a license to steal."