Medical Insurance Fraud Articles

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How Insurers Exploited Medicare Advantage for Billions - The …

https://www.nytimes.com/2022/10/08/upshot/medicare-advantage-fraud-allegations.html

Most large insurers in the program have been accused in court of fraud. 2495 Accused of fraud by whistle-blower Accused of fraud by U.S. government Overbilled, …

DOJ charges 14 people in alleged Covid-related …

https://www.cnbc.com/2021/05/26/doj-charges-14-people-in-alleged-health-care-fraud-related-to-covid-19.html

Federal prosecutors have charged 14 people — including a medical doctor and owners of laboratories, pharmacies and a home health agency — in multiple Covid-related fraud …

Fourteen years of manifestations and factors of health …

https://healthandjusticejournal.biomedcentral.com/articles/10.1186/s40352-021-00149-3

We recognized the elements of fraud and its dependence on the legal framework and health coverage. From this analysis, we propose the following definition: …

The Challenge of Health Care Fraud – NHCAA

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

The National Health Care Anti-Fraud Association (NHCAA) estimates that the financial losses due to health care fraud are in the tens of billions of dollars each year. A …

What Should Health Care Organizations …

https://journalofethics.ama-assn.org/article/what-should-health-care-organizations-do-reduce-billing-fraud-and-abuse/2020-03

In 2016, the Centers for Medicare and Medicaid Services (CMS) spent $1.1 trillion on health coverage for 145 million Americans, $95 …

11 defendants plead guilty in $300 million …

https://www.cbsnews.com/dfw/news/11-defendants-plead-guilty-healthcare-fraud-case/

DALLAS (CBSDFW.COM) - U.S. Attorney for the Northern District of Texas Chad E. Meacham announced that on April 20, 2022, 11 defendants charged in a $300 million healthcare fraud …

Top Healthcare Fraud Takedowns of 2020

https://revcycleintelligence.com/news/top-healthcare-fraud-takedowns-of-2020

The Department of Justice recently reported that it has charged over 300 individuals this year for their involvement in healthcare fraud, waste, and abuse …

Healthcare billing fraud: 9 recent cases - Becker's Hospital Review

https://www.beckershospitalreview.com/legal-regulatory-issues/healthcare-billing-fraud-9-recent-cases.html

From Cincinnati-based Bon Secours Mercy Health agreeing to pay $1 million to settle allegations that it improperly billed Medicare, to a Florida physician being …

Doctor allegedly took $26 million from insurers …

https://abcnews.go.com/US/doctor-allegedly-26-million-insurers-phony-medical-procedures/story?id=69017228

Degraft-Johnson ran the Heart and Vascular Institute of Northern Florida in Tallahassee and is accused of submitting false claims to health insurance agencies for procedures and obtaining …

Seven charged for roles in a $110 million compound drug …

https://www.justice.gov/usao-sdtx/pr/seven-charged-roles-110-million-compound-drug-scheme

U.S. Attorney's Office, Southern District of Texas. McALLEN, Texas – A compound pharmacy owner, three marketers, a referring physician and two clinic office …

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