Healthcare IT News - Telehealth

SEPTEMBER 20, 2021

Department of Justice announced this past week that it was bringing criminal charges against 138 total defendants for their alleged participation in various healthcare fraud schemes, resulting in about $1.4 billion in alleged losses. More than $1.1 billion of that loss involved allegedly fraudulent claims related to telemedicine.

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Electronic Health Reporter

FEBRUARY 27, 2025

The firm stated that its investigation identified […] The article Bias Capital Withdraws $25 Million Investment from Parker Health Amid Fraud Concerns appeared first on electronichealthreporter.com.

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Healthcare Dive

DECEMBER 4, 2023

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.

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Healthcare IT News - Telehealth

FEBRUARY 22, 2021

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. The DOJ describes the case as involving one of the largest healthcare fraud schemes in U.S. Kelly Wolfe and her company, Regency, Inc.,

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Healthcare Dive

JULY 6, 2022

Cases ranged from improper psychiatric treatment to providing false Medicare claims and illegal kickback schemes.

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Healthcare Dive

JULY 25, 2022

The special alert to healthcare providers describes how fraudsters recruit and reward practitioners in schemes to exploit the growth of telemedicine.

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Healthcare Dive

AUGUST 20, 2024

The insurer, which did not admit wrongdoing, agreed to the settlement on the eve of a jury trial.

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Healthcare Dive

JULY 17, 2024

A Pennsylvania pension fund had argued Centene board members failed in their oversight responsibilities and ignored red flags about a Medicaid overbilling scheme.

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Healthcare IT News - Telehealth

DECEMBER 17, 2021

Department of Justice announced this past Friday that it had charged four people, one of whom is a licensed physician, in an international telehealth fraud and kickback scheme. million in a case the DOJ described as one of the "largest healthcare fraud schemes in United States history. WHY IT MATTERS. " ON THE RECORD.

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Healthcare IT News - Telehealth

JANUARY 27, 2021

Department of Justice announced Monday that four people and one company have recently pleaded guilty in a telemedicine pharmacy healthcare-fraud conspiracy that allegedly lasted for years. "Telemarketing fraud is a major threat to the integrity of government and commercial insurance programs," said Derrick L. ON THE RECORD.

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Healthcare IT News - Telehealth

APRIL 21, 2022

Attorney's Office for the Eastern District of New York announced Thursday that an orthopedic surgeon had been arrested and charged with healthcare fraud. Federal law enforcement has brought the hammer down on alleged telehealth fraud in several highly publicized cases. " ON THE RECORD.

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Compliancy Group

FEBRUARY 25, 2025

Details of the healthcare fraud plea are provided below. The elaborate healthcare fraud conspiracy involved a multi-step process: First, Schreck would offer to connect pharmacies, durable medical equipment (DME) suppliers, and marketers with telemedicine companies. A healthcare fraud conspiracy fee, essentially.

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Healthcare IT News - Telehealth

JULY 22, 2022

billion in alleged fraud involving telehealth, phony genetic testing and durable medical equipment. "The Department of Justice is committed to prosecuting people who abuse our healthcare system and exploit telemedicine technologies in fraud and bribery schemes," said Assistant Attorney General Kenneth A. WHY IT MATTERS.

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American Medical Compliance

MARCH 6, 2025

Fraud, Waste, and Abuse (FWA) remain critical challenges in the healthcare industry, impacting patient care, financial integrity, and regulatory compliance. These safe harbors help distinguish lawful financial arrangements from those that could lead to fraud, waste, or abuse.

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Hall Render

MARCH 24, 2025

Under federal law, the public disclosure bar prohibits a relator from bringing an FCA lawsuit based on fraud that has already been disclosed through certain public channels. Court of Appeals Shuts Down Recycled Fraud Claims Under Public Disclosure Bar appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

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AIHC

FEBRUARY 17, 2025

When Audit Managers Knowingly Skew Audit Results Written by Carl J Byron , CCS, CHA, CIFHA, CMDP, CPC, CRAS, ICDCTCM/PCS, OHCC and CPT/03 USAR FA (Ret) Fraud cannot be eliminated. No system is completely fraud-proof, as any system can be bypassed or manipulated. on fraud detection and prevention in healthcare. median loss.

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Healthcare Dive

JULY 12, 2024

The Department of Justice investigation follows a multi-year international probe into Steward's deal to improve three hospitals in Malta.

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Healthcare Dive

SEPTEMBER 25, 2024

Regulators say Medicare needs more data and oversight to avoid fraud and misuse. Digital health advocates argue the service is still crucial for managing chronic conditions.

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Hall Render

NOVEMBER 1, 2024

Health care fraud remains a significant focus for federal and state enforcement agencies, with particular attention placed on the integrity of Medicaid and Medicare billing. This disparity highlights the difficulty in accurately assessing the risks and potential penalties associated with health care fraud violations.

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Healthcare Dive

JANUARY 17, 2025

Healthcare fraud investigations accounted for more than half of the Department of Justice’s settlements and judgments in 2024, which totaled north of $2.9

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Healthcare Dive

APRIL 21, 2022

Defendants — including doctors, medical business executives and fake vaccination card manufacturers — caused nearly $150 million in false billings to federal programs, the DOJ alleged.

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Healthcare Dive

JULY 20, 2022

Regulators are primarily targeting laboratory owners and operators who paid illegal kickbacks and bribes in exchange for patient referrals from doctors working with fraudulent companies.

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Fierce Healthcare

JUNE 13, 2024

The CEO and clinical president of telehealth startup Done have been arrested and charged with fraud, accused by federal authorities of participating in a scheme to distribute Adderall online.

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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.

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Fierce Healthcare

OCTOBER 27, 2023

The Department of Justice (DOJ) has filed charges against a former HealthSun Health Plans executive as part of an alleged multimillion-dollar Medicare fraud scheme. | The Department of Justice has filed charges against a former HealthSun Health Plans executive as part of an alleged multimillion-dollar Medicare fraud scheme.

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Fierce Healthcare

DECEMBER 12, 2022

House and Senate Dems want CMS to drop ACO REACH members due to fraud concerns. Mon, 12/12/2022 - 16:08.

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Healthcare Dive

JUNE 29, 2023

The multi-state bust that targeted 78 individuals represents “one of the largest healthcare fraud schemes ever prosecuted by the Justice Department,” Attorney General Merrick Garland said.

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Healthcare IT Today

JUNE 2, 2023

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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Fierce Healthcare

DECEMBER 15, 2022

Genetic testing lab owner convicted in $463M Medicare fraud case. Thu, 12/15/2022 - 14:14.

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Compliancy Group

JANUARY 23, 2025

A classic example is Medicare fraud. Providers who bill Medicare for services they did not actually provide and who present the bill with the knowledge that the service was not performed have committed Medicare fraud. The DOJ has focused much of its anti-fraud efforts on pursuing these cases, litigating several of them in 2024.

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Healthcare Dive

OCTOBER 10, 2024

Here are the legal issues providers need to know as litigation increases around healthcare fraud and abuse, according to two experts.

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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!

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HIT Consultant

JUNE 6, 2024

Healthcare fraud is a significant issue in the U.S. the cost of healthcare fraud in the country is close to $100 billion a year. Recent advances in technology are now enabling government agencies to be more effective in their efforts to detect and prevent healthcare fraud. According to the U.S. Department of Justice (D.O.J.),

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Fierce Healthcare

FEBRUARY 23, 2024

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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Fierce Healthcare

FEBRUARY 15, 2024

ACOs could face lasting financial difficulties because of a recent, alleged $2 billion Medicare catheter fraud scheme. Seven durable medical equipment companies cost the Medicare system $2 billion in payments, the National Association of ACOs (NAACOS) told the federal government in recent months.

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Healthcare Dive

JUNE 29, 2022

Lawmakers on both sides of the aisle are taking a harder look at coverage denials, fraud and waste in the popular MA program.

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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.

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