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Zone program integrity contract (ZPIC) audits are on the rise. These audits can result in evidence given to the Department of Health and Human Services (HHS) Office of Inspector General (OIG) and potentially result in criminal charges. ZPICs were created by the...
The Department of Justice (DOJ) released the federal indictments for a group of individuals charged in one of the largest cases of healthcare fraud in recent history. The case is the result of a joint operation involving many agencies including the Federal Bureau of...
A recent investigation has resulted in evidence that appears to support allegations a group of hospital executives were more concerned about profits then patient care. The study is an extension of a previous report finding top executives and board members of a local,...
The United States Department of Health and Human Services (HHS) continues to crackdown on allegations of healthcare fraud. The government will strike both before and after the fraudulent activity occurs. Predictive analytics allow federal investigators to flag...
New York Attorney General Letitia James has accused a Long Island pharmacist of a complex, multi-million-dollar Medicaid scam. The scam, according to prosecutors, involved pharmacies throughout New York including locations in Manhattan and the Bronx. The state...
The state of Texas recently accused Xerox, the giant in the copying industry, of violating its Medicaid Fraud Prevention Act. The law makes it illegal to fraudulent charge the state’s Medicaid system.More on the Texas Medicaid Fraud Prevention Act: The...
Technology has touched every area of our lives. We have devices in our pockets that allow us to be in constant contact with our loved ones and colleagues, our vehicles are beginning to use the technology needed to drive themselves and our refrigerators can tell us...
The United States Department of Justice created the Health Care Fraud Unit to investigate allegations of health care fraud. This unit does not just focus on doctors and hospitals. Any professional that submits a bill with Medicare, Medicaid or other health insurance...
The Federal Bureau of Investigation (FBI) estimates health care fraud costs the United States billions of dollars every year. Artificial intelligence (AI) specialists claim they have a tool that can help the government recoup these losses. These specialists state they...
The health care market is evolving. Physicians are becoming more specialized and patients are more likely to see many different providers. A single patient may have one doctor to manage diabetes, another to manage heart issues and still a third for problems with their...