Compliancy Group

APRIL 25, 2024

Components of Medicare Fraud, Waste, and Abuse Training One of the most important elements of CMS Medicare fraud, waste, and abuse training is defining and differentiating these three terms : Fraud is the deliberate attempt to obtain financial gain through deceptive means, such as providing false information. See how it works!

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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. a driver’s license, passport, or other ID card) via their smartphone or computer’s webcam.

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Fraud Ransomware Licensing Governance 105

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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Fraud Telemedicine Nurses Licensing 138

American Medical Compliance

APRIL 6, 2023

Prosecutors stated that if they passed, they would be able to seek licenses and jobs in numerous locations. Incidence of Healthcare Fraud Numerous scammers view this as a method to make quick, yet unlawful, money. Incidence of Healthcare Fraud Numerous scammers view this as a method to make quick, yet unlawful, money.

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Compliancy Group

DECEMBER 15, 2023

Differentiating Fraud, Abuse, and Waste Detecting and stopping fraud, abuse, and waste rely on distinguishing these behaviors in the healthcare context. What is Healthcare Fraud? Providers commit Medicare and Medicaid fraud when they knowingly submit or contribute to the submission of a false claim for financial gain.

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Verisys

NOVEMBER 3, 2023

Healthcare Fraud Crackdown! Here is a round up of bad actors: Entity Fraud Cardiac imaging company and founder to pay historic $85M settlement Full Story Genomic Health Inc. Here is a round up of bad actors: Entity Fraud Cardiac imaging company and founder to pay historic $85M settlement Full Story Genomic Health Inc.

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Provider Trust

APRIL 30, 2024

This year, as always, the Medicaid Fraud Control Units (MFCUs) released an annual report dissecting the exclusions, enforcements, and overall takeaways from their work throughout the previous fiscal year (FY). This year’s report also shows greater participation from managed care organizations (MCOs) as a key trend.

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Fierce Healthcare

JUNE 28, 2024

Attorney General Merrick Garland announced Thursday a two-week operation in which 193 people across the country, including 76 licensed healthcare providers, were charged for their alleged participa | The cases highlighted by law enforcement involved medically unnecessary amniotic wound grafts, diverted HIV medications, online distribution of Adderall (..)

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Bill of Health

NOVEMBER 17, 2024

by Rebekah Ninan A recent lawsuit in the Southern District of New York has alleged that the health insurance company Anthem Blue and Cross Blue Shield violated state laws and committed fraud by maintaining “ghost networks” of mental health providers. A second license could cost a provider hundreds if not thousands of dollars.

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Provider Trust

JUNE 1, 2022

Organizations across the healthcare continuum have experienced several workforce trends that are creating gaps in license monitoring and verifications. In this post, we’ll explore three current challenges impacting the healthcare license and credential verification process. See our Telehealth Credentialing Guide for more information.

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Provider Trust

APRIL 26, 2023

However, this solution comes with its share of compliance risks, especially if interstate licenses are involved. A travel nurse could be hired to work at a hospital located in a state where they are not licensed to practice. For starters, each state has its own process, rules, and regulations for monitoring licensed nurses.

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The Health Law Firm Blog

APRIL 18, 2022

Board Certified by The Florida Bar in Health Law On March 13, 2022, a licensed professional counselor (LPC) was sentenced to nearly five years in prison for defrauding the Connecticut Medicaid Program of more than $1.3 By George F. Indest III, J.D., million, announced the U.S. Attorney for the U.S. District of Connecticut. [.].

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Med-Net Compliance

OCTOBER 27, 2022

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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Nursing Homes Fraud US Department of Health and Human Services Nurses 59

Healthcare IT News - Telehealth

APRIL 10, 2019

Hundreds of thousands patients were lured into worldwide criminal healthcare fraud schemes involving telemedicine and durable medical equipment (DME) executives, according to the FBI and Department of Justice. WHY IT MATTERS. billion in losses. ON THE RECORD.

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Provider Trust

MAY 9, 2023

What is a Medicaid Fraud Control Unit (MFCU)? Fraud and abuse are unfortunate realities of the healthcare industry. Hundreds of claims and investigations are carried out yearly to combat the growing number of providers, organizations, and entities contributing to fraud and abuse within state and federal healthcare programs.

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Verisys

DECEMBER 8, 2022

A professional career can take a provider across state lines, and through an evolution of various license types. In order to see the full picture of an individual, the comprehensive whole of each state licensing board across all license types must be searched. Take the process back another step.

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Provider Trust

MARCH 13, 2023

State licensing boards nationwide have annulled the licenses of dozens of nurses who obtained fake degrees and used them to gain or secure employment. In Delaware, 26 nursing licenses were revoked when the nurses’ credentials were tied to the scheme. ProviderTrust recommends conducting license verification monthly.

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The Health Law Firm Blog

AUGUST 22, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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The Health Law Firm Blog

JULY 17, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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The Health Law Firm Blog

AUGUST 8, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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The Health Law Firm Blog

JUNE 26, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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HIT Consultant

DECEMBER 10, 2021

What You Should Know: – Report from Codoxo that finds 10-15% of telehealth claims fall outside of approved CMS codes and indicates a high potential for rapidly increasing fraud schemes (and provider coding errors) in a new telehealth era. Licensed Clinical Social Worker. Report Background. Physician/Psychiatry.

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The Health Law Firm Blog

JANUARY 2, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On October 18, 2023, an ex-Navy officer was sentenced to 30 months in prison after he pleaded guilty to conspiracy to commit wire fraud for his role in an [.] Indest III, J.D.,

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The Health Law Firm

FEBRUARY 14, 2022

million Medicare fraud scheme asked a New Jersey court to eliminate a bail condition. According to the brief, the defendants argued that the court should not get involved in a licensed physician's medical practice. Indest III, J.D., The doctor argued that the bail condition impeded his ability to practice medicine.

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Provider Trust

JANUARY 26, 2022

It’s no secret–when fraud enters healthcare, things get risky. But how exactly does the HHS-OIG (Office of Inspector General), the main body responsible for conducting investigations into suspected fraudulent activity, address healthcare fraud and assess future risk of these bad actors?

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Verisys

AUGUST 13, 2024

Verisys is a trusted partner that ensures the safety of your business from potential risks and guarantees the validation of identities, licenses, and absence of sanctions, exclusions, or debarments within your business network, enabling you to secure your path to success. The post July 2024 Bad Actors Roundup appeared first on Verisys.

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Verisys

AUGUST 13, 2024

Verisys is a trusted partner that ensures the safety of your business from potential risks and guarantees the validation of identities, licenses, and absence of sanctions, exclusions, or debarments within your business network, enabling you to secure your path to success. The post July 2024 Bad Actors Roundup appeared first on Verisys.

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Verisys

MAY 13, 2024

With Verisys, you can instantly validate identities, licenses, and ensure there are no sanctions, exclusions, or debarments associated with anyone in your business network. Here is a round up of bad actors: Doctor sentenced to 10 years in prison for unlawfully dispensing controlled substances ( Full Story ) Doctor Convicted for $5.4M

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Verisys

APRIL 2, 2024

Here is a round up of bad actors: Physician Fraud Physician pays $1.8M Million Medicare Fraud Scheme ( Full Story ) New York-Presbyterian/Brooklyn Methodist Hospital Settles Health Care Fraud Claims for $17.3 Here is a round up of bad actors: Physician Fraud Physician pays $1.8M Secure your success by choosing Verisys.

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AIHC

SEPTEMBER 25, 2024

The American Institute of Healthcare Compliance (AIHC), a Licensing/Certification partner with CMS, provides periodic news blasts highlighting noteworthy cases of fraud, waste, abuse and other violations. Government agencies expect your organization to stay informed. These are free ways to stay informed of lessons learned.

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The Health Law Firm

FEBRUARY 3, 2021

In December 2019, she pled guilty to wire fraud, healthcare fraud, identity theft, and practicing nursing without a license. According to a news release from the US Attorney’s Office, the woman posed as a registered nurse, despite not having a nursing degree or a nursing license, and having no nursing experience.

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The Health Law Firm

OCTOBER 31, 2019

Board Certified by The Florida Bar in Health Law On October 1, 2019, a Florida doctor was implicated in what federal investigators say is one of the largest health care fraud schemes ever charged. The vast fraud scheme totaled $2.1 Indest III, J.D.,

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Verisys

JULY 25, 2024

Here is a round up of bad actors: National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Here is a round up of bad actors: National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 The post June 2024 Bad Actors Roundup appeared first on Verisys.

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Verisys

JULY 25, 2024

Here is a round up of bad actors: National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Here is a round up of bad actors: National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 The post June 2024 Bad Actors Roundup appeared first on Verisys.

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Fraud Nursing Homes COVID-19 Licensing 52

Verisys

JUNE 17, 2024

Verisys is a trusted partner that ensures the safety of your business from potential risks and guarantees the validation of identities, licenses, and absence of sanctions, exclusions, or debarments within your business network, enabling you to secure your path to success. Attorney Announces $2.5 Attorney Announces $2.5

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Verisys

JANUARY 2, 2024

With Verisys, you can instantly validate identities, licenses, and ensure there are no sanctions, exclusions, or debarments associated with anyone in your business network. Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Secure your success by choosing Verisys.

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Provider Trust

JANUARY 18, 2023

In October 2022, the South Carolina Medicaid Fraud Control Unit (SCMFCU) arrested a 37-year-old South Carolina woman named Alyssa Beth Steele for working as a registered nurse despite not having a license. Pursuant to federal regulations, the SCMFCU is authorized to investigate and prosecute any acts of Medicaid provider fraud.

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