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2024 DOJ False Claims Act Settlements in Healthcare Recover $1.67B

Compliancy Group

The federal False Claims Act prohibits someone from knowingly presenting or causing a false claim for payment if the federal government will pay for that claim. A classic example is Medicare fraud. The DOJ has focused much of its anti-fraud efforts on pursuing these cases, litigating several of them in 2024. While the $1.67

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Indiana insurers, hospitals accused of Medicaid fraud in giant whistleblower lawsuit

Fierce Healthcare

Major Indiana managed care organizations and health systems are blamed for defrauding the state Medicaid system by tens, if not hundreds, of millions of dollars, says a newly unsealed whistleblower | A newly unsealed lawsuit alleges major health insurers and health systems defrauded Indiana Medicaid by hundreds of millions of dollars, with the government (..)

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Understanding Whistleblower Protections in Healthcare – Legal Obligations and Compliance Implications

AIHC

Atkins, PhD, MSW, LMSW, CPC, CIGE The governments new whistleblower complaint portal launched in April 2025 emphasizes the importance of complying with regulations related to qui tam suits, OCR investigations and protecting the rights of employees submitting a tip or complaint internally or to authorities. Written by Dr. Stacey R.

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Knowing Your Patient: Helping Healthcare Organizations Prevent Insurance Fraud

Healthcare IT Today

With those competing priorities, fraud prevention does not always make its way to the top of the list of considerations, even when it should. According to the National Health Care Anti-Fraud Association, fraud costs the U.S. healthcare industry more than $50 billion each year. What Exactly is KYP?

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Fraud Schemes in a Telehealth Era: What Healthcare Payers Should Know

HIT Consultant

What You Should Know: – Report from Codoxo that finds 10-15% of telehealth claims fall outside of approved CMS codes and indicates a high potential for rapidly increasing fraud schemes (and provider coding errors) in a new telehealth era. Hospital-Psychiatric Unit. Report Background. Physician/Psychiatry. Psychologist, Clinical.

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Queensland begins telestroke pilot and more briefs

Healthcare IT News - Telehealth

Queensland to pilot telestroke service at Hervey Bay Hospital The Queensland government has designated Hervey Bay Hospital as the pilot site for the upcoming statewide telestroke service. The state government has committed A$5.8 The InterSystems integration also allows didgUgo to leverage AI for fraud prevention.

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AMC President Mark Gutweiler Expands into UAE & Middle East at Arab Health 2025

American Medical Compliance

American Medical Compliance , known for its high-quality, government-approved compliance training, reaffirmed its commitment to assisting healthcare organizations in meeting international regulatory and accreditation standards.