Medicare Archives - Corruption, Crime & Compliance

16 Sep, 2022

DOJ Announces Two Significant Indictments Charging Individuals with Healthcare Fraud

The Justice Department is continuing to use criminal enforcement as an important tool in the fight against healthcare fraud. While the False Claims Act continues its important place in the fight against healthcare fraud, DOJ has used the criminal laws to prosecute players in significant fraud cases. Five Individuals and Two Nursing Facilities, Pittsubrugh, PA: Five individuals and two for-profit skilled nursing facilities were indicted...

General

21 Jul, 2016

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...

General

22 Jun, 2016

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 [email protected]. 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...

General

30 Jul, 2015

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...