article thumbnail

Government watchdog warns of Medicare fraud after relaxing provider requirements

Healthcare Dive

The Government Accountability Office is urging the CMS to resume certain eligibility checks on providers whom they consider at high risk of fraud to the Medicare program.

Fraud 320
article thumbnail

Government expects to recover more than $3B from healthcare fraud, misspent funds in fiscal year 2023

Healthcare Dive

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.

Fraud 246
Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

Hospice Update: Surveyors Called to Identify Quality of Care Concerns and Potential Fraud Referrals

Hall Render

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.

Fraud 80
article thumbnail

DOJ charges dozens in $1.1B telehealth fraud crackdown

Healthcare IT News - Telehealth

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 Companies then allegedly purchased the orders in exchange for bribes or kickbacks and submitted false claims to government insurers.

Fraud 206
article thumbnail

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

Fraud 199
article thumbnail

DMERx VP Pleads Guilty to $1B Healthcare Fraud Conspiracy

Compliancy Group

billion in false and fraudulent claims to Medicare and other government insurers for orthotic braces, prescription skin creams, and other items that were medically unnecessary and ineligible for Medicare reimbursement. In late February of 2025, defendant Gregory Schreck, pleaded guilty to conspiracy to defraud the United States government.

Fraud 52
article thumbnail

DOJ charges four in $37M global telehealth fraud scheme

Healthcare IT News - Telehealth

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. THE LARGER TREND.

Fraud 175