A paramedic alleges his employer terminated his position because he followed a patient’s request instead of adhering to conventional medical practices. The patient was suffering from a serious infection and asked the paramedic not to move forward with an...
Health Care Investigations
ZPIC audits on the rise: Tips for pharmaceutical companies
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...
DOJ pursues healthcare fraud case, alleges billions in violations
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...
Investigators accuse NY hospital execs of conflict of interest
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,...
3 tips to avoid allegations of healthcare fraud
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...
Long Island pharmacist accused of health care fraud
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...
Texas officials accuse Xerox of health care fraud
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...
NY officials remind pharmacies use of ADMs illegal
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...
Acupuncturist faces 65 years in prison for health care fraud
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...
AI: The next tool in the fight against health care fraud?
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...

