Friday, June 19, 2015

National Medicare Fraud Takedown Results

As the Senior Editor of GPC Publications, periodically, like to share the Medicare Fraud that is going on; and the Agency that is Responsible for Catching those that do.
Noting, and imagine that it is not the Government that is Frauding Medicare, BUT the Private Hospitals, Doctors, etc.

BTW, in regards to the Child Protective AGENCY, there is much fraud going on, but to date many have missed it. Much of it is related to Targeted Case Management. Check out this Animated Video as an Introductory to the issues>> The Anatomy of Child Welfare Fraud >>

Anyway, here are some
Enforcement Actions
National Medicare Fraud Takedown Results in Charges Against 243 Individuals for Approximately $712 Million in False Billing
Image of HHS OIG special agent
Attorney General Loretta E. Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced today a nationwide sweep led by the Medicare Fraud Strike Force in 17 districts, resulting in charges against 243 individuals, including 46 doctors, nurses and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings.  In addition, the Centers for Medicare & Medicaid Services (CMS) also suspended a number of providers using its suspension authority as provided in the Affordable Care Act.  This coordinated takedown is the largest in Strike Force history, both in terms of the number of defendants charged and loss amount.   
Attorney General Lynch and Secretary Burwell were joined in the announcement by FBI Director James B. Comey, Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, Inspector General Daniel R. Levinson of the HHS Office of Inspector General (HHS-OIG) and Deputy Administrator and Director of CMS Center for Program Integrity Shantanu Agrawal, M.D.
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Other Actions

  • Florida Physician Agrees to Pay $4 Million and To Accept a 5-Year Exclusion From Medicare to Resolve False Claims Act Allegations (June 17, 2015; U.S. Attorney; Southern District of Florida)
  • Manhattan U.S. Attorney Settles Civil Fraud Claims Against Inspire Pharmaceuticals, Inc. For Its Misleading Marketing Designed To Cause Prescriptions Of Azasite For Non-Fda Approved Uses (June 17, 2015; U.S. Attorney; Southern District of New York)
  • Former Shelby County Hospital CFO Sentenced in EHR Incentive Case (June 17, 2015; U.S. Attorney; Eastern District of Texas)
  • Registered Nurse Co-Owner of Ultimate Care Home Health Services, Inc. Pleads Guilty to Role in Healthcare Fraud Conspiracy (June 16, 2015; U.S. Attorney; Northern District of Texas)
  • State Enforcement Actions Updated
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  • National Coordinator of the Family Survey Program
    When One Deals with the Child Protective AGENCY