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News
Carondelet to pay $35 million in rehab overbilling case
By Modern Healthcare | August 19, 2014 | Basic Web Basic Web Subscription Details
Carondelet Health Network, a Tucson, Ariz.-based division of Ascension Health, has agreed to pay $35 million to settle allegations that two of its hospitals inappropriately billed Medicare and other federal health programs for inpatient rehabilitation care.
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Information
How agents hunt for fraud in trove of Medicare data
By Wall Street Journal | August 15, 2014
Eleven armed FBI agents crept around a stone-and-glass Hollywood Hills, Calif., house just before dawn. An AR-15 rifle and four other guns were registered to the man in the house. He was no drug lord. The target was a doctor who moonlighted as a movie producer. The Justice Department charged Dr.
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News
Ebola cure scams are out there; beware, FDA warns
By Steven Ross Johnson | August 14, 2014 | Basic Web Basic Web Subscription Details
The Food and Drug Administration on Thursday issued a warning to the public after receiving consumer complaints of products being sold online claiming to prevent or treat the Ebola virus that has killed more than 1,000 people across four countries in West Africa.
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News
Suspect HIV drug prescriptions cost Medicare millions
By Bob Herman | August 06, 2014 | Basic Web Basic Web Subscription Details
Medicare paid $32 million in 2012 for HIV drugs that were tied to questionable and potentially fraudulent uses, according to a new report from HHS' Office of Inspector General. In some instances, there was no indication the beneficiaries had HIV.
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News
CHS to pay $97 million to settle short-stay investigation
By Bob Herman | August 04, 2014 | Basic Web Basic Web Subscription Details
For-profit hospital operator Community Health Systems has agreed to pay more than $97 million plus interest to the federal government, settling allegations that it submitted false claims for short-stay admissions that should have been billed as outpatient charges.
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News
Texas kicks off Medicaid contract with Accenture
By Virgil Dickson | August 01, 2014 | Basic Web Basic Web Subscription Details
The Texas Health and Human Services Commission has hired Accenture to take over its Medicaid claims processing work from Xerox.
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Information
U.S. attorneys turn up heat on healthcare fraud
By Associated Press | July 27, 2014
The top federal prosecutors from South Dakota and North Dakota say they have increased their efforts to fight healthcare fraud.
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Magazine
Fictitious applicants easily get ACA subsidies: GAO
By Paul Demko | July 26, 2014 | Print Magazine Print Magazine Subscription Details
While federal courts last week ruled on the legality of insurance subsidies issued from federally run exchanges, Congress was hearing about another, much more dollars-and-cents subsidy issue, namely how easy it apparently is for consumers to lie to obtain subsidies.
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Information
Invoking anti-fraud law, Louisiana doctor gets rich
By Wall Street Journal | July 24, 2014
William LaCorte keeps a half-dozen marble paperweights at his medical practice in Metairie, La., engraved with images of checks from a lucrative sideline: suing companies for alleged healthcare fraud. Dr. LaCorte is a so-called serial whistle-blower, one of the more-prolific plaintiffs among a...
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News
Bogus exchange applications resulted in coverage, GAO says
By Paul Demko | July 23, 2014 | Basic Web Basic Web Subscription Details
A day after federal appellate courts issued conflicting rulings about whether individuals who obtain coverage through the federal exchange are eligible for subsidies, a House subcommittee heard about another aspect of health insurance subsidies, namely that it's apparently easy to obtain them under...
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