Fraud Prevention

Better anti-fraud efforts are not appeasing lawmakers

Better anti-fraud efforts are not appeasing lawmakers

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Long-term care facilities and other Medicare providers increasingly have seen reimbursements influenced by the government's Fraud Prevention System, an official recently told a Congressional panel.

CMS leverages technology in move from 'pay-and-chase' to fraud prevention

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The Centers for Medicare & Medicaid Services will utilize computer technology to shift from detecting and then prosecuting fraud ("pay-and-chase") to preventing it, according to a CMS official who spoke at last week's National HIPAA Summit in Washington, D.C.

Assisted living operators caught in $63 million mental health billing scam

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A pair of Miami-area assisted living facility owners are the latest to be caught in an alleged $63 billion Medicare and Medicaid billing scam, federal authorities say. Ivon Perez and Raymond Rivero admitted their guilt separately in agreements filed late last week with the U.S. District Court for the Southern District of Florida.

CMS is two weeks late issuing report on fraud prevention efforts

CMS is two weeks late issuing report on fraud prevention efforts

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Two Republican Senators want to know why the Centers for Medicare & Medicaid Services is two weeks overdue in issuing a report on the agency's fraud prevention system (FPS).