» UBS Settles Healthsouth Case with Michigan for $117M

UBS Settles Healthsouth Case with Michigan for $117M

Monday, May 17, 2010

Money will go to State Pension Fund to benefit future retirees. Financial services firm UBS and three of its former employees reached a $117 million settlement with Office of the Attorney General (OAG) in Michigan. The amount settles UBS’s financial…

Three Miami-Dade Residents Plead Guilty to Health Care Fraud

Monday, April 19, 2010

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Fake HIV-related treatments said to bilk Medicare for a total of $82 million. The FBI, with a little assistance from its friends in the HHS OIG, helped the feds in Miami net three more people who thought they were smarter…

HHS OIG Recovers $4B in Penalties for Health Care Fraud

Monday, April 19, 2010

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Three-quarters of investigations in 2009 involved shams; OIG reveals investigation secrets. While many of us would prefer to quickly forget 2009—the HHS OIG had a pretty good year. The OIG walked away with $4 billion in its hands at the…

Texas Doctor Charged in PT Fraud Cases

Monday, April 19, 2010

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Aside from illegal drug distribution, feds link her to a $30M physical therapy scam. You might be too young to get benefits, but you’re never too old to commit Medicare fraud: That’s the latest message in the constant string of…

OIG Wants CMS to Train RACs to Spot Fraud

Monday, February 22, 2010

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Dirty little secret: The RACs flagged $1.03 billion in improper payments — and only 2 cases of fraud. If you’re wondering how often a Recovery Audit Contractor’s review of overpayments turns into a federal fraud investigation, a

J&J PowerPoint Kickback Case Lesson: Keep Those Intentions Clean!

Monday, February 1, 2010

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3 precautions every provider should take when presenting finanicials. The feds continue to hassle Johnson & Johnson and Omnicare for their financial relationship, and now they’ve got a PowerPoint presentation to add to their contention that…

Prepare for Increased Fraud Enforcement with Medicaid Compliance Plan

Monday, January 11, 2010

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Medicaid compliance differs from Medicare compliance in 3 key ways. Given that both the feds and the states are ramping up their efforts in the area of Medicaid fraud enforcement, it’s time for your practice…

Latest on Home Health Fraud Busts

Monday, December 7, 2009

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76K for “vacation pay?” Where can we get a gig like that? Recent fraud busts are threatening home care providers with a bad reputation. In Memphis, an owner of a 30-year-old home health agency was sentenced to 18 months in…

NJ Practice Busted for Providing PT, Claiming Surgeries

Wednesday, July 29, 2009

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Modifier misuse, POS coding errors might be partly responsible for one physician’s legal troubles. A New Jersey practice allegedly overbilled Medicare by almost $5 million by fraudulently reporting lymphedema procedures to its carrier. Although the practice billed for surgery that…

HEAT in Houston & Other Urban Areas

Tuesday, July 21, 2009

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Texas Medical Center Lesson Learned: Health care providers in medical centers harbor fraudsters in their midst —and increased federal scrutiny. If you’re a health care provider near a university medical center…

HC Compliance Essentials

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