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Two Healthcare Organizations Caught Up in Medicare Fraud Schemes

Compliancy Group

Fraud in healthcare has run rampant in recent years, as evident by two incidents in which healthcare organizations billed insurance companies for things patients never received. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received. Attorney Philip R.

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Florida woman to pay $20.3M after using telemedicine to shield alleged fraud

Healthcare IT News - Telehealth

Department of Justice announced earlier this month that an Indian Rocks Beach, Florida-based woman has pleaded guilty to conspiracy to commit healthcare fraud and filing a false tax return. Department of Health and Human Services Office of Inspector General, in a statement. have also agreed to pay up to $20.3

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How to Prevent Medicare Advantage Fraud, Waste, and Abuse

Provider Trust

US Department of Health and Human Services (HHS) Office of Inspector General Christi A. Grimm gave a lecture at the 2023 RISE National Conference in early March 2023 about Medicare Advantage, or Medicare Part C, and the increased risk of fraud due to the rapid growth of healthcare programs.

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Nursing Home Psychologist Convicted of Healthcare Fraud Scheme

Med-Net Compliance

A federal jury convicted a licensed Illinois psychologist of defrauding Medicare over the course of several years by causing the submission of fraudulent claims for psychotherapy services he never provided. The psychologist was convicted of four counts of healthcare fraud.

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Michigan Podiatrist Convicted of $1.8 Million Healthcare Fraud Scheme

Med-Net Compliance

million scheme to defraud Medicare by billing for services under another doctor’s name after Medicare revoked his privileges to participate in the program. According to court documents and evidence presented at trial, the podiatrist was revoked from participating in the Medicare program in January 2015.

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Michigan Registered Nurse Pleads Guilty in COVID-19 Vaccination Record Card Fraud

Med-Net Compliance

A registered nurse from a veteran’s hospital in Detroit pleaded guilty to charges related to COVID-19 vaccination record cards fraud. Issue: Legitimate vaccination cards are being stolen from healthcare facilities and then used in a fraudulent manner. Participating in the fraud can result in the person(s) being prosecuted.

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Significant Upcoding Risks Emerge with Medicare Advantage

YouCompli

Approximately 65 million Americans are enrolled in Medicare – about 34 million in traditional Medicare and the rest in Medicare Advantage. Traditional Medicare is administered by the federal government, and individuals pay a separate monthly premium for hospital visits, doctors/outpatient, and prescription drugs.