Articles Tagged With: fraud
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DOJ, OIG Changing Enforcement Policies for COVID-19 Era
The federal government’s fraud and abuse enforcement priorities are shifting in response to COVID-19. Risk managers should be ready to adapt their compliance programs in response to the changing risks.
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Prosecutors May Look for COVID-Related Restructuring Fraud
Risk managers should be on the alert for fraud and abuse related to reimbursement issues and financial restructuring related to the COVID-19 pandemic. With the high reimbursement rates for a COVID-19 diagnosis for hospitals and an additional large sum for the use of a ventilator, the potential for fraud and abuse in hospitals is substantial.
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Tenet to Pay $513 Million for Fraud, Kickbacks
Tenet Healthcare Corporation and two of its Atlanta-area subsidiaries have agreed to pay more than $513 million to resolve criminal charges and civil claims relating to what the government says was a scheme to defraud the United States and to pay kickbacks in exchange for patient referrals.
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‘Bait and Switch’ Advertising Brings $16 Million Verdict
A recent $16 million verdict illustrates the risk faced by a hospital when its marketing promises too much and misleads patients. -
Whistleblower revealed in $70 million fraud case
Federal officials have revealed the identity of a Fort Lauderdale, FL, orthopedic surgeon who blew the whistle on a hospital system that ended up paying nearly $70 million to settle charges of healthcare fraud.
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Blue Cross Blue Shield employees charged with taking and sharing data screen shots
Eleven people have been charged after a Blue Cross Blue Shield of Michigan (BCBSM) employee allegedly printed and shared screen shots of more than 5,000 subscriber profiles. The 11 people are charged with identity theft and credit card fraud, in what some observers are calling an example of how criminals can get past even the best HIPAA security measures.