‘Parasite’ Esformes convicted in $1.3B nursing home fraud, could face remaining years in prison
By
Marty Stempniak
Apr 08, 2019
Florida long-term care business mogul Philip Esformes faces the possibility of decades in prison after being convicted Friday in the largest healthcare fraud scheme ever charged by the U.S. Justice Department.
Former hospital director, physician’s assistant plead guilty in $1 billion Esformes fraud case
By
Marty Stempniak
Jan 24, 2019
Two major players in a billion-dollar nursing home-related fraud case have pled guilty and could face years in prison.
Long-term care providers would receive more education from auditors under draft Medicare bill
By
Tim Mullaney
Aug 11, 2014
Medicare auditors would boost outreach and education efforts to long-term care and other providers under the provisions of a draft bill introduced Thursday by Rep. Kevin Brady (R-TX), chairman of the Ways...
CMS fails to measure outcomes of the zone program integrity contractor program: government report
By
Tim Mullaney
Nov 26, 2013
The Centers for Medicare & Medicaid Services is not thoroughly assessing how well zone program integrity contractors are contributing to Medicare anti-fraud efforts, according to a new report from the...
Congressional lawmakers grill top ALJ on appeals backlog, say too many providers are being put out of...
By
Tim Mullaney
Jul 11, 2014
Efforts to root out Medicare fraud have put far too many above-board providers in auditors’ crosshairs, leading to a staggering backlog of appeals that has no easy fix, Congressional lawmakers and...
Government saved $17.6 billion in 2011 due to fraud prevention programs
Nov 16, 2011
A government crackdown on improper payments in federal programs, such as Medicare and Medicaid, cut wasteful payments by $17.6 billion in 2011, the Office of Management and Budget reported Tuesday. The...
CMS improperly measuring outcomes, report claims
By
James M. Berklan
Jan 01, 2014
So far, some providers have been put through a wringer without enough verification that it’s been worth it, according to a new Government Accountability Office report.
X-ray exec who targeted nursing homes is sentenced in $3.7 million fraud case
By
Joe Bush
Oct 03, 2022
A man who charged Medicare and Medicaid for X-rays he had not taken of people who had died has been sentenced to 15 years in jail and ordered to pay almost $2 million in restitution.
Medicare enhances readability and fraud protections with streamlined benefit statements
By
McKnight's Staff
Mar 08, 2012
Medicare recipients soon will be reaping the benefits of simplified benefit statements and will see added protections against Medicare fraud, the Centers for Medicare & Medicaid Services announced Wednesday.
Judge dismisses claims of ‘nationwide’ Medicare fraud in Omnicare antipsychotics case
By
McKnight's Staff
May 23, 2013
Long-term care pharmacy Omnicare will not face charges that it engaged in “nationwide” Medicare fraud for off-label antipsychotics prescriptions, a federal judge recently ruled. However, the...