Healthcare Fraud is an important problem that needs more attention from both the federal government and the health services communities. The United States loses at least $60 billion in healthcare fraud every year, and some organizations put the cost as high as 10% of the nation's total ...
Health Care Fraud is a Crime Health care fraud is committed when someone intentionally submits, or causes someone else to submit, false or misleading information for use in determining the amount of health care benefits payable. That is a crime. Any per
The same AI technologies that help combat fraud in financial services and the public sector can also be applied to healthcare. Insurance companies can use pattern and anomaly detection to look for claims that seem atypical, either from the provider or the patient, and scrutinize billing data for...
United to fight fraud and corruption in healthcare. Lo Tignov provides investigative services, research and medical expertise to help government entities, private health insurers, self-insured employers, and whistleblowers expose healthcare fraud and recover improper payments. By collaborating with the ...
In Texas, a supplier of durable medical equipment was found guilty of five counts of healthcare fraud due to submission of false claims to Medicare. The court sentenced the supplier to 120 months of incarceration and restitution of $1.6 million.1Raritan Bay Medical Center agreed to pay the gov...
Community Health Center, which has a dozen primary care, dental and other clinics in Connecticut, is notifying nearly 1.1 million people - including pediatric patients and their parents and guardians - that their information was potentially stolen in a cyberattack detected earlier this month. « ...
Industry-leading healthcare insurance companies rely on the HCFSPlatform®for Fraud, Waste, Abuse, and Error to deliver millions of dollars in savings, recoveries, and prevented loss each year – a critical component of your companyʼs payment integrity strategy. ...
These cases underscore the importance of compliance for entities engaged in government contracts and healthcare services. Tags Fraud & Abuse Categories Health Law Highlights Whether “Willful” Under the Anti-Kickback Statute Requires Knowledge that the Conduct is Unlawful Post author By WadeEmmert ...
State and Federal Healthcare Cyber Regs to Watch in 2025 Marianne Kolbasuk McGee • January 23, 2025 Under the Trump administration, the proposed update to the HIPAA Security Rule - issued in the final weeks of the Biden administration - is likely to get trimmed but not totally cut, pred...
We maintain a strict non-retaliation policy for all reports made in good faith. Examples of potential Medicare fraud: A health care provider — such as a physician, pharmacy, or medical device company — billing for services that you never received A supplier — for example, a medical device...