Fraud And Abuse

On September 8, 2021, the Department of Justice, in connection with the Office of Inspector General, announced a settlement of $17 million against a home health agency that purchased two home health agencies...

Providers shouldn’t assume that federal authorities will slow down enforcement efforts in the aftermath of the coronavirus pandemic. In fact, they should expect authorities to “step up” enforcement...

There are many benefits to communicating to your cohorts in neighboring states, and not the least of it may be knowing when a provider is kicked out of Medicaid.

Promoting quality care in long-term care settings is one of the top management challenges facing the Department of Health and Human Services in the next year, according to a report from the agency’s...

A bill in the House of Representatives aims to create a “trusted provider” status in the Medicare program, which would potentially streamline the reimbursement and claims review processes for...

The Centers for Medicare & Medicaid Services should move faster to make changes based on Medicare audits and should have more direct oversight over Medicaid, according to bipartisan legislation introduced...

To combat fraud and abuse, the Centers for Medicare & Medicaid Services plans to make provider-specific Minimum Data Set information available to health plans, according to a notice in Wednesday’s...

Tennessee-based nursing home operator Grace Healthcare LLC will pay the federal government more than $2.7 million, settling charges that Grace violated the False Claims Act by billing Medicare for unnecessary...

A newly unveiled database created by the Pew Charitable Trusts provides comprehensive information about states’ strategies for combating Medicaid fraud and abuse.