Category archive: Health Care Fraud

Massive National Health Care Fraud Takedown

Last week, the OIG reported charges against 301 individuals for approximately $900 Million in false billing as part of the largest false claim takedown. The takedown focused on a broad range of providers including home health companies, physicians, physical and occupational therapy clinics, infusion clinics, mental health providers, DME suppliers, and compounding pharmacies. Of importance,…

Elder Fraud in Health Care Targeted by the DOJ

The U.S. Department of Justice (“DOJ”), in trying to initiate quicker enforcement actions and prosecutions, has created several Elder Justice Task Forces to target health care providers who commit crimes in the service of the elderly. The Task Forces are comprised of representatives from federal, state and local law enforcement, the U.S. Department of Health…

False Claims Update: OIG Continues to Focus on Ambulance Services

Reduction of fraud and abuse remains a focus of the government’s efforts to ensure providers accountability.  Recently, the Department of Justice (DOJ) announced a $3.199 Million settlement of alleged False Claims Act violations resulting from an ambulance “swapping” arrangement between a skilled nursing home and ambulance service (Regent settlement). Once again, the Department of Justice…

Anti-Kickback Update – HHS-OIG Settles Ambulance Swapping Case $3 Million Settlement from Nursing Home in Ambulance Swapping Case

Demonstrating the government’s commitment to combat health care fraud and keeping providers accountable, the U.S. Attorney’s office of Southern District announced that Regent Management Services L.P., a long term provider, agreed to pay approximately $3.199 Million to settle allegations that it received kickbacks from ambulance companies for referrals of Regent’s Medicare and Medicaid patients needing…

Fraud & Abuse Alert: OIG targets Excluded Employees

The OIG has demonstrated an increased focus on investigating employers to determine whether any employees are excluded from participating in Federal health care programs. When the OIG investigations reveal excluded employees, who allegedly provided items and services to Federal health care programs beneficiaries resulting in payments to the employers, the OIG has sought and obtained…

ALERT – Clinical Labs under Scrutiny by OIG

As health care costs rise and providers are faced with challenges to meet the needs and demands of consumers; Medicare looks for questionable payments made to providers to ensure federal dollars for healthcare are spent for medically necessary services as it seeks to reduce fraud and abuse in the provision of health care. One such…

HEAT Settlement Resolves Alleged Inducement of Medicare and Medicaid Business

Next time you wonder how seriously the Department of Justice (DOJ) and its Health Care Fraud Prevention and Enforcement Action Team (HEAT) takes fraud and abuse, be assured they are very serious. This recently announced settlement arose from allegations the DOJ received from a whistleblower that Rite Aid provided gift cards to Medicaid and/or Medicare…

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