American Medical Compliance
JUNE 21, 2024
Fraud, waste, and abuse (FWA) in healthcare present significant challenges, causing substantial financial losses, eroding public trust, and compromising the quality of patient care. Unlike fraud, waste is not necessarily intentional but results from inefficiencies.
Health Law Checkup
JANUARY 20, 2022
Can a whistleblower successfully allege Medicaid/Medicare fraud if the whistleblower lacked direct access to records related to the alleged fraud? While the appellate circuits are still split on this issue, we look at recent decisions that indicate a possible shift in the Seventh Circuit’s pleading standard.
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Bill of Health
SEPTEMBER 2, 2022
Following the findings of “The Age of Fraud,” I’d hypothesize that this way in which we think of scams both feeds and is fed by the apparent misconception that they are a relatively bounded problem for older adults. Social views about fraud and scams would, no doubt, be difficult to change quickly.
MedTrainer
MAY 3, 2024
Healthcare fraud, waste, and abuse is a costly problem for both public and private payers. The National Health Care Anti-Fraud Association estimates financial losses due to healthcare fraud could be as much as $300 billion annually. Keep in mind that these are just examples of provider fraud!
Mobi Health News
OCTOBER 15, 2020
The online appointment booking service called for a dismissal and re-filing of the former CEO's lawsuit, and outlined a financial rebound since his dismissal in a new blog post.
Hall Render
JANUARY 29, 2025
The Centers for Medicare & Medicaid Services (CMS) is reinforcing its emphasis on hospice quality of care and identifying fraud. CMSs Focus on Surveys and Fraud Identification The CMS Memo highlights the dual purpose of hospice surveys: Ensuring Compliance : Evaluating whether hospice providers meet CoPs.
Hall Render
NOVEMBER 21, 2023
The United States District Court for the Eastern District of Wisconsin recently issued a decision involving protections for employees whose jobs involve the investigation of fraud. This category of individuals is sometimes called a “fraud alert employee.” Since 2009, the FCA’s anti-retaliation provision,(codified at 31 U.S.C.
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