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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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Louisiana Woman Arrested for Stealing from Nursing Home Resident

Healthcare Compliance Blog

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. It is alleged that between November 18, 2021, and December 30, 2021, the woman used a credit card that was stolen from a resident for 259 transactions.

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Montana Nurse Sentenced to Prison for Stealing Opiates from Healthcare Facilities

Med-Net Compliance

A Montana nurse who admitted to stealing opiates while working at multiple healthcare facilities was sentenced to one year and one day in prison, to be followed by one year of supervised release. The government alleged in court documents that the defendant diverted opiates in 2021 while working at multiple healthcare facilities.

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South Carolina Woman Arrested for Exploiting Residents of an Assisted Living Facility

Healthcare Compliance Blog

The South Carolina Attorney General announced that his office’s Medicaid Fraud Control Unit (SCMFCU) had arrested a 57-year-old woman on two counts of Exploitation of a Vulnerable Adult and two counts of Breach of Trust with Fraudulent Intent, value of $10,000 or more.

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State and Federal enforcement agencies anticipating more complex investigations as COVID-era practices emerge

YouCompli

Unger, Chief of Medicaid Fraud Division, Office of the Massachusetts Attorney General; and Patrick Callahan, Healthcare Fraud Unit, US Attorney’s Office. Unger and Callahan addressed the Massachusetts Health and Hospital Association’s Healthcare Legal Compliance Forum in December 2021. Read a summary.

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Hospice Update: CMS Proposes Informal Dispute Resolution Program, Starting Special Focus Program and Change of Ownership Restrictions 

Hall Render

Selection Approach In establishing the proposed SFP, CMS examined the Special Focus Facility program for nursing homes and its methodology for facility selection. CMS’ goal is to select SFP hospices starting in 2024.

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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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