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Medicare/Medicaid Fraud Archives

Justice Department forms first Health Care Fraud Unit

After last month's takedown of some 400 medical professionals accused of $1.3 billion in false billings, the Justice Department intends to remain vigilant in its fight against healthcare fraud. It has just announced the creation of the nation's first Health Care Fraud Unit to focus on issues like kickback schemes, upcoding and false diagnoses.

400+ healthcare professionals accused of Medicare/Medicaid fraud

The Justice Department has just announced what it calls the "largest health care fraud takedown operation in American history." 412 doctors, nurses, pharmacists and other licensed medical professionals have been charged with a massive kickback scheme involving the prescription of opioid medications. The scheme allegedly involved $1.3 billion in false billing to Medicare, Medicaid and TRiCARE insurance, and people were charged in 41 federal districts.

The University of Rochester is ordered to repay Medicaid $100,000

The University of Rochester's Medical Center (URMC) has agreed to reimburse both the state and federal governments the $113,722.10 that they are alleged to have illegally pocketed. URMC is alleged to have violated both the New York False Claims Act as well as federal law when it improperly used a billing code in filing claims through its Flaum Eye Institute.

Have you noticed time discrepancies in Medicaid billing?

There are many different forms of fraud that involve billing Medicaid. In some cases, a doctor, billing specialist or medical business will intentionally bill for drugs, procedures or services that were never administered or performed. In other cases, doctors or dentists perform unnecessary medical or dental procedures on unwitting patients. One of the less known forms of Medicaid fraud is time theft, where a doctor, therapist or other professional bills for time when no services were provided to the client.

Have you noticed time discrepancies in Medicaid billing?

There are many different forms of fraud that involve billing Medicaid. In some cases, a doctor, billing specialist or medical business will intentionally bill for drugs, procedures or services that were never administered or performed. In other cases, doctors or dentists perform unnecessary medical or dental procedures on unwitting patients. One of the less known forms of Medicaid fraud is time theft, where a doctor, therapist or other professional bills for time when no services were provided to the client.

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