Healthcare fraud rampant, but OIG refines its focus on nursing homes
By
Neville M. Bilimoria
Feb 19, 2024
For 2024, healthcare fraud has already been rampant, according to the U.S. Department of Health and Human Services Office of Inspector General. But on Jan. 19, the OIG took a specific stance with...
It’s time to let crime pay
By
Kimberly Marselas
Dec 13, 2022
If gung-ho prosecutors get a little more screen time around here while some of our usual sources close up shop for a couple weeks, don’t rush past. There are plenty of lessons to be learned.
Private equity in the crosshairs
By
Jonathan H. Ferry
Aug 20, 2021
Private equity investors in nursing homes should brace and prepare for an active near-term enforcement environment. Congressional skepticism of private equity involvement in healthcare, developments in...
Overflow crowd sees former American Senior Communities CEO get 9½ years for $19 million fraud, kickback...
By
James M. Berklan
Jul 02, 2018
A U.S. District Court judge leaned closer to prosecuting attorneys’ recommendations than defense attorneys’ on Friday and sentenced former nursing home executive James Burkhart to 9½-years...
CMS should intensify Medicaid eligibility checks at certain facilities, government asserts
By
Elizabeth Newman
Jun 28, 2018
The Centers for Medicare & Medicaid Services should prioritize fingerprint-based criminal background checks and conduct site visits to high-risk providers to mitigate Medicaid fraud, a government watchdog...
Hospice provider settles massive case for $2.5 million, claiming documentation errors
By
Kimberly Marselas
May 23, 2018
Once accused of defrauding Medicare of $14 million in false claims in a single year, a Florida hospice provider has agreed to pay $2.5 million to resolve the allegations.
Also in the News for Monday, April 23
Apr 23, 2018
Nurse accused of covering up patient’s fatal fall fails to surrender license, may still be practicing … Miami man gets 97 months in $10 million home health fraud case … Strong winds partially...
Lawmakers target SNFs’ big payer for fraud, waste cuts
By
Kimberly Marselas
Apr 08, 2018
A pair of Congressional subcommittees focused on oversight have banded together to examine ways to reduce Medicaid fraud and waste.
Lawsuit claims nursing home managers scammed resident, sold her house, gave her only $2k for it
By
Kimberly Marselas
Apr 02, 2018
An Illinois woman is suing a nursing home and two former employees for allegedly selling her house against her wishes — then paying her only $2,000 for it.
OIG: Medicare needs to do more to prevent fraud and waste related to chiropractic care
By
Kimberly Marselas
Feb 20, 2018
Previous controls have not done enough to reduce fraud and waste in connection to chiropractic care for Medicare patients, according to a review issued by a federal watchdog Friday.