Tagged: healthcare fraud

CCOs and the C-Suite

Let’s start out with something ironic – the C-Suite typically resists the need for ethics and compliance training, as well as other compliance controls, claiming that they know everything about ethics and compliance. Unfortunately, when a member or members of the C-Suite commit misconduct, the consequences can be devastating for the company. We all know high-profile instances of C-Suite misconduct involving bribery, fraud, and theft....

Check Up on Healthcare Fraud Prosecutions

Chief compliance officers face an overwhelming level of risk in the healthcare sector. I do not mean to belittle the risks of corruption, AML, sanctions and other risks typically associated with global companies. Healthcare companies face an extraordinary mix of risks, including fraud, data security, bribery/anti-kickback, and Stark Law violations. The False Claims Act statute is a prosecutor’s dream, and organizations and individuals face extraordinary...

Compliance Reminder — DOJ Announces Largest Healthcare Fraud Takedown

Jacqui Merrill, an Associate at The Volkov Law Group, rejoins us for a posting on DOJ’s largest healthcare fraud takedown.  Jacqui’s profile is here and she can be reached at jmerrill@volkovlaw.com. On Wednesday, June 22, 2016, the DOJ announced the largest nationwide heath care fraud takedown in history, which resulted in criminal and civil charges against 301 individuals for alleged participation in health care fraud...

Defrauding Medicare — A Little Help from the Private Sector?

The headline on Medicare last  week was astounding — $60 billion (not million) was lost each year to Medicare fraud, large numbers of fraudulent providers were providing fake or badd addresses – meaning locations including hamburger stands, vacant lots, mailbox shops. According to a recent GAO report (here), Medicare pays money to fraudsters at approximately 23,400 fake or bad addresses (22 percent of all provider...