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Community Health Systems unit settles false-billing case for $262M

Community Health Systems unit settles false-billing case for $262M

By Alex Kacik  |  September 25, 2018

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.

Blood-testing startup Theranos said to be closing

Blood-testing startup Theranos said to be closing

By Associated Press  |  September 05, 2018

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.

Data Points: Cracking down on Medicaid fraud

Data Points: Cracking down on Medicaid fraud

By Modern Healthcare  |  August 25, 2018

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.

GAO urges scrutiny of Medicaid managed-care organizations

GAO urges scrutiny of Medicaid managed-care organizations

By Susannah Luthi  |  August 21, 2018

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.

Fraud fears rise as feds expand access to association health plans

Fraud fears rise as feds expand access to association health plans

By Harris Meyer  |  June 20, 2018

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.

Theranos CEO Elizabeth Holmes charged with criminal fraud

Theranos CEO Elizabeth Holmes charged with criminal fraud

By Associated Press  |  June 18, 2018

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.

Indictment: Man used not-for-profit to cheat Medicare out of $1M

Indictment: Man used not-for-profit to cheat Medicare out of $1M

By Associated Press  |  March 19, 2018

Prosecutors say a 43-year-old New Jersey man and others used The Good Samaritans of America and offers of free ice cream to gain access to low-income senior housing complexes and convince them to submit to unnecessary genetic testing.

Holmes surrenders control of Theranos, pays $500K fine

Holmes surrenders control of Theranos, pays $500K fine

By Associated Press  |  March 14, 2018

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."

HHS, VA to team up on anti-fraud crackdown

HHS, VA to team up on anti-fraud crackdown

By Susannah Luthi  |  January 23, 2018

The two largest healthcare payers plan to work together to curb fraud and abuse within their networks in a rare collaboration.

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