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Government watchdog warns of Medicare fraud after relaxing provider requirements

Healthcare Dive

The Government Accountability Office is urging the CMS to resume certain eligibility checks on providers whom they consider at high risk of fraud to the Medicare program.

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Government expects to recover more than $3B from healthcare fraud, misspent funds in fiscal year 2023

Healthcare Dive

The HHS’ Office of the Inspector General’s report tallied 707 criminal enforcement actions and 746 civil actions for fraud and misspent funds in programs like Medicare and Medicaid.

Fraud 246
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OIG report suggests telehealth fraud rare in Medicare

Healthcare Dive

A small proportion of providers that billed for telehealth — 1,714 out of 742,000 — posed a high risk of fraud or abuse to Medicare in COVID-19’s first year, regulators found.

Fraud 276
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DOJ charges 18 in COVID healthcare frauds totaling $490M

Healthcare Dive

It's the largest enforcement action against COVID-19 healthcare fraud schemes to date, according to regulators.

Fraud 263
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Everything You Wanted to Know About FACIS, but Didn’t Know to Ask

Speaker: Amy Anderson

Maintaining compliance and safeguarding against fraud and abuse in today’s changing healthcare landscape can be challenging. FACIS® helps organizations mitigate patient and organizational risk. Most healthcare organizations screen and monitor providers against the OIG but that’s only ONE of FACIS®’ primary sources.

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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.

Fraud 340
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Medicare Advantage fraud in DOJ's crosshairs after agency reports $2.7 billion in settlements

Fierce Healthcare

billion in settlements and judgments was related to health-related matters in the last fiscal year, about two-thirds of the monetary fraud recoveries by t | Health fraud settlements under the False Claims Act exceeded $1.8 Under the False Claims Act, more than $1.8 billion last year, according to the Department of Justice.

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