New payment models clash with fraud laws; waivers might not be the answer, official says
By
Elizabeth Newman
Nov 21, 2014
Healthcare payments linked to the quality of care are causing challenges to existing fraud and abuse laws, a government official said Wednesday.
Nursing home psychiatrist in federal custody on 52 counts of fraud, including upcoding
Oct 17, 2014
Authorities have arrested a nursing home psychiatrist and charged him with 52 counts of healthcare fraud, the U.S. Attorney for the Northern District of Texas announced Thursday.
Senators blast Medicare audits, say RAC payments should be changed
By
Tim Mullaney
Jul 10, 2014
The Medicare claims review process is unfairly burdening healthcare providers and failing to improve program integrity, due in part to the payment system for certain auditors, Senate leaders said during...
Brokers stole dying nursing home residents’ identities to carry out a lucrative fraud, SEC charges
By
Tim Mullaney
Mar 14, 2014
Two investment brokers and their associates are facing charges that they stole nursing home residents’ personal information to perpetrate annuities fraud, the U.S. Securities and Exchange Commission...
Psychiatry company settles Medicare fraud allegations for $1 million
By
Elizabeth Newman
Jul 22, 2013
A New York company that provided psychiatry services to nursing home residents with dementia has settled a whistleblower Medicare fraud case for $1 million.
Nursing home operator to repay $1 million in Medicaid fraud case
By
Tim Mullaney
Jul 19, 2013
A South Carolina man will pay $1 million in restitution for his role in a nursing home Medicaid fraud scheme, the state’s attorney general announced Thursday.
Lawmakers call for public disclosure of Medicare payments, ask for input on post-acute reforms
By
McKnight's Staff
Jun 20, 2013
The battle against Medicare waste, fraud and abuse heated up on Capitol Hill this week. Lawmakers introduced a bill to make Medicare claims and payments publicly available and asked for provider input...
HHS: Self-disclosure saves providers money in cases of Medicare and Medicaid fraud
By
McKnight's Staff
Apr 18, 2013
Long-term care providers who self-disclose potential Medicare and Medicaid fraud will likely benefit from lower repayment amounts, according to updated guidance released Wednesday. It is the first time...
Fraud-fighting efforts not much to brag about
By
John O'Connor
Nov 30, 2012
In what has become a frequent event, the Inspector General at the Department of Health and Human Services has just issued yet another report that crows about heroic fraud-fighting efforts.
The projected recoveries to the federal government from fraud-related audits and investigations are expected to rise 33% — or by $1.7 billion — in fiscal 2012, the Department of Health and Human Services...