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New York Optician Convicted of Medicaid Fraud for Nursing Home Residents

Healthcare Compliance Blog

A New York optician has pled guilty to grand larceny for submitting false claims for optician services that he alleged were for specific nursing home residents, but which were never provided. On January 27, 2022, he was sentenced to 90 days in state prison, followed by 5 years’ probation, and was ordered to pay $74,00 in restitution.

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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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Nursing Home Investigation Leads to Michigan Sentinel Project’s First Criminal Case

Healthcare Compliance Blog

Complaints of resident abuse in a Michigan nursing home led to an investigation by the Michigan Office of Attorney General’s Health Care Fraud Division, working with the Michigan Sentinel Project. The investigation determined that a nurse was working at the nursing home while her license was suspended, which is a felony.

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North Dakota CNA Found Guilty after Injuring Nursing Home Resident by Improper Lifting

Med-Net Compliance

The evidence at the trial showed that the CNA performed an improper, one-person lift of a nursing home resident which resulted in severe and painful injuries to the resident. The CNA is being held in custody until the date of her sentencing hearing on November 29, 2022. “[The

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Louisiana Woman Arrested for Stealing from Nursing Home Resident

Healthcare Compliance Blog

A Louisiana woman was arrested on January 31, 2022, for allegedly stealing from a resident where she was employed. The woman is charged with 259 counts of access device fraud, 16 counts of identity theft, and four counts of contributing to the delinquency of a juvenile.

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DOJ Recouped $2.2 Billion Under FCA in 2022

Hall Render

billion in False Claims Act (“FCA”) related settlements and judgments in the federal fiscal year 2022. Whistleblowers continue to be one of the federal government’s greatest assets in FCA cases, as whistleblowers filed 652 qui tam suits in 2022 with recovery totaling $1.9 Health Care Fraud Actions Medicaid. Standard of Care.

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Highlights from the HHS-OIG 2023 Spring Semiannual Report

Provider Trust

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has released its latest 2023 Spring Semiannual Report to Congress, providing a comprehensive overview of its activities from October 2022 to March 2023. OIG continues to work tirelessly to identify instances of fraud, waste, and abuse and prosecute offenders.