Category: General

Private Health Insurance Efforts to Fight Fraud

Private Health Insurance Efforts to Fight Fraud

Healthcare fraudsters do not discriminate between private and public medical insurance.  Fraudsters use similar schemes to defraud Medicare and Medicaid and private insurance companies.  Most healthcare providers bill public and private payers.  For example, a health care provider may be billing Medicare, Medicaid and several private health plans (in-network and out-of-network).  Private insurance companies also provide insurance as Medicare Parts C and D contractors or...

Rising from the Dead: Anti-Corruption Enforcement in Canada

Rising from the Dead: Anti-Corruption Enforcement in Canada

I find the so-called “vampire” cultural phenomena scary – I do not understand what is so entertaining about “ordinary” people who can suddenly turn into vampires, let alone enter into “serious” relationships with each other or with so-called “normal” humans. Maybe I am stuck in the past when “Night of the Living Dead” was more my cup of tea.  Whatever your attitude toward death and...

Dancing Around the Edges:  A Journey in the FCPA Guidance

Dancing Around the Edges: A Journey in the FCPA Guidance

I am really enjoying reading and re-reading the FCPA Guidance.  It is a fascinating document, well written and chock full of salient points, messages, explicit and implicit. For me, the most important issues are those that are in the so-called “gray area.”  Some of the hypotheticals and the anonymous declinations are easy calls – after reading them, I am positive of the answer.  The descriptions...