“Fraud, Waste, and Abuse” (often abbreviated as “FWA”) is a term used in the healthcare industry, including health insurance, to refer to practices that result in unnecessary or excessive healthcare costs, improper payments, or other fraudulent activities. Waste, abuse, and fraud in health...
See: Health Care Fraud Defense: Arrests Based Upon Medicare, Medicaid, or TriCare Insurance Claims. This leads us to a consideration of future health care fraud investigation and prosecution targets in terms of health care practitioners, practices, and providers, as well as t...
Since Health Insurance Marketplace open enrollment began Nov. 1, 2023, an estimated 4.6 million people have selected plans for coverage in 2024, according to the Centers for Medicare and Medicaid Services. This includes: 920,000 people who enrolled in a plan through the Health Insurance Marketpla...
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Typically, internal investigators are employees within the organization, often part of the Human Resources team. They can swiftly address minor concerns, leverage organizational familiarity, and maintain control over the investigation process. Additionally, internal investigations may be more cost-effective....
Ensuring Stark Law, HIPAA, Medicare, Medicaid, Childrens Health Insurance P... May 25, 2022 • CLE • CLE On-Demand This CLE webinar will guide healthcare counsel on preparing for the end of the public health emergency (PHE). The panel will review the waivers and modifications put in...
3.1 HealthCare.com makes money when we allow a Network Partner, for example, an insurance company or licensed broker, to help you with an insurance inquiry or when we sell your Information to a Network Partner. We ourselves do not sell insurance....
Insurance Plan Flies Americans to Mexico for Prescription Drugs on the Cheap According to the U.S. International Trade Commission, nearly 1 million Californians travel to Mexico every year to buy prescription drugs, and as many as 320,000 other Americans travel abroad every year for health care ...
United States Supreme Court, where eight justices adopted theexactlegal theory we set forth in our initialHealth Republiccomplaint. As a result, the entire health insurance industry was able to collect three years’ worth of unpaid risk corridors amounts that they had previously been forced to ...
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