Top Health Care Fraud Schemes

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Busted: The top healthcare fraud schemes of Q3 2023

(3 days ago) WEBBusted: The top healthcare fraud schemes of Q3 2023. As we review the third quarter of 2023, we’re confronted with a resurgence of fraud, waste, and abuse (FWA) cases that continue to target both public and private payers. These cases persistently employ a …

https://resources.cotiviti.com/fraud-waste-and-abuse/busted-the-top-healthcare-fraud-schemes-of-q3-2023

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Justice Department Charges Dozens for $1.2 Billion in Health Care …

(3 days ago) WEBPrior to the charges announced as part of today’s nationwide enforcement action and since its inception in March 2007, the Health Care Fraud Strike Force, which …

https://www.justice.gov/opa/pr/justice-department-charges-dozens-12-billion-health-care-fraud

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Office of Public Affairs National Health Care Fraud Enforcement

(8 days ago) WEBThe Department of Justice announced today criminal charges against 138 defendants, including 42 doctors, nurses, and other licensed medical professionals, in …

https://www.justice.gov/opa/pr/national-health-care-fraud-enforcement-action-results-charges-involving-over-14-billion

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Busted: The top healthcare fraud schemes of Q1 2021

(5 days ago) WEBThey conspired to use the home care services provider to defraud Medicare and MassHealth of a minimum of $100 million by getting referrals through the payment of kickbacks. False healthcare benefit scheme: $134M . …

https://blog.cotiviti.com/busted-the-top-fraud-schemes-of-q1-2021

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Busted: The top fraud schemes of Q1 2022 - Cotiviti

(5 days ago) WEBWith help from the National Health Care Anti-Fraud Association (NHCAA), we’ve gathered some of the most noteworthy cases of FWA from January through March. Lab test …

https://blog.cotiviti.com/busted-the-top-fraud-schemes-of-q1-2022

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DOJ targets nationwide health care fraud scheme involving over …

(9 days ago) WEBThe Justice Department announced a sweeping enforcement effort Wednesday aimed at health care, telemedicine and illegal prescription schemes …

https://www.cnn.com/2023/06/28/politics/doj-health-care-fraud-scheme/index.html

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Health Care Fraud — FBI

(8 days ago) WEBHealth care fraud is not a victimless crime. It affects everyone and causes tens of billions of dollars in losses each year. The FBI is the primary agency for investigating health care fraud, for

https://www.fbi.gov/investigate/white-collar-crime/health-care-fraud

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Dozens in 16 States Charged With Health Care Fraud Schemes, …

(6 days ago) WEBWASHINGTON (AP) — The Justice Department has charged dozens of people in several health care fraud and prescription drug schemes, including one …

https://www.usnews.com/news/business/articles/2023-06-28/dozens-in-16-states-charged-with-health-care-fraud-schemes-including-1-9b-in-bogus-claims

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Ten charged in business email compromise and money laundering …

(9 days ago) WEBNovember 18, 2022 — The U.S. Department of Justice announced charges today against 10 defendants in multiple states in connection with multiple business email compromise …

https://www.irs.gov/compliance/criminal-investigation/ten-charged-in-business-email-compromise-and-money-laundering-schemes-targeting-medicare-medicaid-and-other-victims

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Laboratory Owners Charged in $36M COVID-19 Testing Fraud …

(Just Now) WEBAn indictment was unsealed today in the Southern District of Florida charging three men for their alleged roles in an approximately $36 million health care fraud, wire …

https://www.justice.gov/opa/pr/laboratory-owners-charged-36m-covid-19-testing-fraud-scheme

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The Ultimate Guide to US Healthcare Fraud Schemes Case IQ

(3 days ago) WEBMedical Identity Theft. Medical identity theft is defined as "the misuse of a person's medical identity to wrongfully obtain health care goods, services, or funds." In 2016, 27 million …

https://www.caseiq.com/resources/the-ultimate-guide-to-us-healthcare-fraud-schemes/

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10 popular health care provider fraud schemes - Fraud Magazine

(7 days ago) WEB(Also see the ACFE's 2013 Fraud Examiners Manual's section on health care fraud — beginning with 1.1101 — to learn more about these and other types of fraud schemes.) …

https://www.fraud-magazine.com/article.aspx?id=4294976280

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The Challenge of Health Care Fraud – NHCAA

(6 days ago) WEBEveryone Shares the Burden of Health Care Fraud. In 2018, $3.6 trillion was spent on health care in the United States, representing billions in health insurance claims. It is …

https://www.nhcaa.org/tools-insights/about-health-care-fraud/the-challenge-of-health-care-fraud/

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Insurance Fraud Statistics 2024 – Forbes Advisor

(8 days ago) WEBHealth care insurance fraud, particularly Medicare and Medicaid fraud, Select Region False Injuries, Non Disclosure of Relevant Information Among Top …

https://www.forbes.com/advisor/insurance/fraud-statistics/

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Nurse Practitioner Sentenced in Twelve Million Dollar Health Care …

(3 days ago) WEBPROVIDENCE, R.I. – A registered nurse and nurse practitioner, who defrauded commercial health insurers and Medicare of nearly $12 million by devising …

https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/press-releases/nurse-practitioner-sentenced-twelve-million-dollar-health-care-fraud-scheme

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Top Ten Healthcare False Claims Act Recoveries for 2023

(3 days ago) WEBThis past year was another big year for DOJ enforcement under the False Claims Act, the government’s primary fraud-fighting tool. And as we noted in our recent …

https://constantinecannon.com/whistleblower/whistleblower-insider-blog/top-ten-healthcare-false-claims-act-recoveries-2023/

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Aggregated Risk How to find fraud in complex health care …

(8 days ago) WEBareas of interest, and a reactive posture to fraud schemes that have been perpetrated. The size of the health care FWA problem is substantial, with the Centers for Medicare and …

https://www2.deloitte.com/content/dam/Deloitte/us/Documents/us-how-to-find-fraud-in-complex-healthcare-systems-with-risk-triangulation.pdf

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Unveiling $5.4M Healthcare Fraud: The Case of Adarsh Gupta and …

(4 days ago) WEBThe charges brought against him included three counts of health care fraud and two counts of false statements relating to health care matters. With a maximum penalty of …

https://www.msn.com/en-us/money/companies/unveiling-5-4m-healthcare-fraud-the-case-of-adarsh-gupta-and-the-medicare-scheme/ar-AA1nN93v

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New York Doctor Indicted on Health Care Fraud and Kickback …

(4 days ago) WEBAlexander Baldonado, a medical doctor in New York, was recently charged via a grand jury superseding indictment with engaging in a health care fraud and illegal …

https://www.policymed.com/2024/04/new-york-doctor-indicted-on-health-care-fraud-and-kickback-scheme.html

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Change Healthcare hackers broke in using stolen credentials — …

(5 days ago) WEBThe ransomware gang that hacked into U.S. health tech giant Change Healthcare used a set of stolen credentials to remotely access the company’s systems …

https://techcrunch.com/2024/04/30/uhg-change-healthcare-ransomware-compromised-credentials-mfa/

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Hospice care scam: FBI issues warning about fraudsters signing …

(7 days ago) WEBThey have agents in the office dedicated to health care fraud. For news updates, follow Samica Knight on Facebook , X and Instagram . Report a correction or typo

https://abc13.com/hospice-care-scam-fbi-warning-lifesaving-medical-how-to-prevent-fraud/14742000/

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Medical Equipment Suppliers Convicted of Health Care Fraud

(6 days ago) WEBThe Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this …

https://www.justice.gov/opa/pr/medical-equipment-suppliers-convicted-health-care-fraud

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Las Vegas woman sentenced to prison for $1 million Medicaid …

(5 days ago) WEBMay 1, 2024 — A Las Vegas woman, Henrietta Binford, was sentenced Monday to 10 months in prison and ordered to pay $1,250,223.39 in restitution for defrauding the …

https://www.irs.gov/compliance/criminal-investigation/las-vegas-woman-sentenced-to-prison-for-1-million-medicaid-fraud-scheme

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Healthcare insurance fraud detection using data mining

(2 days ago) WEBHealthcare programs and insurance initiatives play a crucial role in ensuring that people have access to medical care. There are many benefits of healthcare …

https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-024-02512-4

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Pelham Manor man pleads guilty in health care fraud and kickback …

(Just Now) WEBManishkumar Patel, of Pelham Manor, has pleaded guilty to health care fraud, wire fraud, and violation of the anti-kickback statute. News 12 Staff Apr 29, 2024, …

https://newjersey.news12.com/pelham-manor-man-pleads-guilty-in-health-care-fraud-and-kickback-scheme

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District of New Jersey Four Men Indicted for Their Roles in $35

(3 days ago) WEBMatawan Cardiologist Admits Defrauding Health Insurance Companies of More Than $1.9 Million Through Health Care Fraud Scheme TRENTON, N.J. – The …

https://www.justice.gov/usao-nj/pr/four-men-indicted-their-roles-35-million-pharmacy-compounded-medication-scheme

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Former VA Psychologist Sentenced to Prison for Submitting False …

(4 days ago) WEBTheresa A. Kelly, 57, pleaded guilty in October 2023 to one count of concealing a material fact by trick, scheme or device; three counts of making or using a false …

https://www.shorenewsnetwork.com/2024/05/02/former-va-psychologist-sentenced-to-prison-for-submitting-false-medical-documents-health-care-fraud/

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FBI: New Mexico's seniors lost over $17 million to scams and fraud

(7 days ago) WEBThe 2020 report on elder fraud shows more than 800 elderly New Mexicans reported losing a little over $7 million. Now, the number of reports has decreased …

https://www.krqe.com/news/new-mexico/new-mexicos-seniors-lost-over-17-million-to-scams-last-year/

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Penetratin­g the industry: Medical claims fraud - PressReader

(7 days ago) WEBThis could include exaggerati­ng the cost of medical care, claiming phantom injuries, or fabricatin­g lost wages due to the accident. Summary of case studies. The …

https://www.pressreader.com/botswana/mmegi/20240503/281728389595270

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U.S. Attorney's Office Announces the Formation of Multi-Agency …

(6 days ago) WEBCOLUMBIA, S.C. — Together with state and federal partners, U.S. Attorney Adair F. Boroughs announced the formation of the Palmetto Health Care Fraud Task …

https://www.justice.gov/usao-sc/pr/us-attorneys-office-announces-formation-multi-agency-health-care-fraud-task-force

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Surge in fraud for those 60 or older costs them billions, FBI says

(Just Now) WEBThe FBI's report on fraud schemes targeting the elderly found that Americans over 60 lost more than $3.4 billion to scams in 2023, with tech support and data …

https://www.foxbusiness.com/economy/surge-fraud-those-60-older-costs-them-bilions-fbi-says

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Doctor And Three Others In Bergen County Charged In $10 Million …

(6 days ago) WEBAllegedly Paid and Received Kickbacks in Connection with Medically Unnecessary Prescriptions for Pain Creams. NEWARK, N.J. – A doctor and three …

https://www.justice.gov/usao-nj/pr/doctor-and-three-others-bergen-county-charged-10-million-health-care-fraud-scheme

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