During a routine check by HHS' Office of Inspector General, which investigates Medicare and Medicaid fraud, special agents in Florida noticed that a local company had recently changed owners and had another address in their building. But that location didn't have any actual employees. It was n...
The lawsuit, filed in a trial court, claims Point32 did not pay for medically necessary treatment. ABA argues Point32 has a ghost network, meaning its in-network provider directory is limited and not accepting new patients. ABA also said Point32 stopped paying for medical claims “without sign...
By making it easier to address frauds that might otherwise be dismissed as too small to prosecute, the AFCA addresses a significant gap in the enforcement of the False Claims Act, which has traditionally focused on larger, more visible frauds. The legislation passed the House of Representatives ...