Five metro Detroit doctors and one from the Grand Rapids area have been indicted for allegedly running a $464 million healthcare fraud scheme that involved millions of opioid drugs and unnecessary medical procedures in Southeastern Michigan.
The owner of a Detroit medical clinic was sentenced to more than 13 years in prison and ordered to pay millions of dollars in restitution after running an $8.9 million healthcare fraud scheme.
A federal judge temporarily shut down a South Florida-based operation called Simple Health Plans that allegedly collected more than $100 million from tens of thousands of consumers for plans dubbed Trumpcare and simplemedicareplans.
Health Management Associates allegedly billed government healthcare programs for inpatient services that should have been billed as outpatient or observation, paid physicians for patient referrals and submitted inflated claims for ER facility fees.
The once-heralded blood-testing startup Theranos is shutting down, according to a media report. Theranos was unable to sell itself and is now looking to pay unsecured creditors its remaining cash of about $5 million in the upcoming months.
CMS Administrator Seema Verma last week said that her agency is working closely with states, the Government Accountability Office and HHS' Office of Inspector General to root out fraud in Medicaid.
The U.S. comptroller general urged a Senate panel to tighten oversight of Medicaid providers and managed-care plans, and criticized the Obama administration's lax auditing of Medicaid insurers as millions joined the rolls through expansion.
Providence Health and Services has been sued by a data analysis firm that claimed the 50-hospital system pushed its doctors to add complications or comorbidities to treatment documents so they could get higher Medicare reimbursement.
Regulators and insurance experts worry the Trump administration's new rule expanding association health plans will spark a surge of insurance fraud and insolvencies that plagued consumers and healthcare providers in the past.
Federal prosecutors indicted Elizabeth Holmes for allegedly defrauding investors, doctors and the public as the head of the once-heralded blood-testing startup Theranos. Federal prosecutors also brought charges against the company's former second-in-command.
The U.S. Justice Department charged a former investigator for health insurer Anthem Blue Cross, a physician and three others for submitting false claims to insurers.
Elizabeth Holmes, a Stanford University dropout once billed as the "next Steve Jobs," has forfeited control of Theranos, the blood testing startup she founded, and will pay $500,000 to settle charges that she oversaw a "massive fraud."