Compliance Fraud Medicare 
American Medical Compliance
OCTOBER 25, 2024
Compliance isn’t just a box to check—it’s a vital responsibility that safeguards patient well-being and protects organizations from significant financial losses. A powerful way to ensure this is through regular compliance audits. This is to confirm that staff are properly trained in compliance protocols.
Hall Render
JANUARY 29, 2025
The Centers for Medicare & Medicaid Services (CMS) is reinforcing its emphasis on hospice quality of care and identifying fraud. Hospice surveys are performed before their initial certification for Medicare participation. Identifying Fraud : Detecting practices that jeopardize patient safety or Medicare program integrity.
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AIHC
APRIL 22, 2025
This article illustrates how certified compliance professionals play a pivotal role in protecting whistleblowers and preventing retaliation. Introduction Healthcare compliance professionals are often the first line of defense when systems break down. Healthcare fraud accounts for a significant portion of FCA activity.
Hall Render
NOVEMBER 1, 2024
Health care fraud remains a significant focus for federal and state enforcement agencies, with particular attention placed on the integrity of Medicaid and Medicare billing. He was also ordered to pay $557,000 in restitution to Indiana Medicaid and Medicare. As such, providers should prioritize billing compliance.
Compliancy Group
FEBRUARY 25, 2025
billion in false and fraudulent claims to Medicare and other government insurers for orthotic braces, prescription skin creams, and other items that were medically unnecessary and ineligible for Medicare reimbursement. Details of the healthcare fraud plea are provided below. A healthcare fraud conspiracy fee, essentially.
Compliancy Group
JANUARY 23, 2025
A classic example is Medicare fraud. Providers who bill Medicare for services they did not actually provide and who present the bill with the knowledge that the service was not performed have committed Medicare fraud. Medicare Advantage Matters Medicare Part C is the largest part of Medicare.
Medisys Compliance
MARCH 31, 2025
Introduction For many physician practices, Medicare beneficiaries represent a significant portion of their patient population. However, navigating the complexities of Medicare billing can be a challenging task, especially when considering its distinct differences from private insurance models.
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