Thanks for printing!  Don't forget to come back to Healthcare Compliance Pros for fresh articles!

Medical Professionals Charged with Health Care Fraud

It was reported last week that the Medicare Fraud Strike Force charged 90 individuals for approximately $260 million in false billing. The defendants who were charged are accused of various health care fraud-related crimes, including conspiracy to commit health care fraud, violations of the anti-kickback statutes and money laundering.

The defendants allegedly participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and often never provided.¬  For many of the cases, court documents allege that patient recruiters, Medicare beneficiaries, and others were paid cash kickbacks in return for supplying beneficiary information to providers, so that providers could then submit fraudulent bills to Medicare for services that were medically unnecessary or never performed.

All of these cases that were announced are being prosecuted and investigated by Medicare Fraud Strike force teams.¬  Collectively the doctors, nurses, licensed medical professionals, health care company owners and others who are being prosecuted and investigated, are accused of conspiring to submit approximately $260 million in fraudulent billings.

These cases serve as an important reminder to be mindful of CMS and OIG Medicare Fraud and Abuse guidelines.¬  If you need to brush up on CMS and OIG Medicare Fraud and Abuse guidelines, or if you haven‚Ä™t yet taken the OIG/CMS Fraud Waste Abuse course, now is as good a time as any to do so.¬  Our OIG/CMS Fraud Waste Abuse course includes important policies and procedures, such as Billing for Medically Unnecessary Services and Billing for Items or Services Not Actually Rendered, to name a few.

In addition to training, we have valuable resources available to you on our website, such as our reference guides. The OIG/CMS Fraud Waste and Abuse reference guide includes valuable information to assist you with staying in accordance with laws, regulations, and guidelines, which minimizes the risk that fraud, waste, abuse or inefficiency will occur.

If you have any additional questions about OIG/CMS Fraud, Waste and Abuse or any other questions, please do not hesitate to contact one of our professional consultants.

Return to the Home Page