Over the past several years, IT experts have been frantically directing their attention towards healthcare, clamoring for the industry to improve cybersecurity. Last week's Anthem hack has brought many of those concerns to life. While many have pointed to the immediate financial impact of the hack, consequences surrounding medical fraud could leave a lasting impression.
Read any FBI or Department of Justice release and you're bound to find a strongly worded statement from a prosecutor, investigator or, if the case is big enough, the Department of Health and Human Services Secretary or the Attorney General. Read more ...
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Aetna has filed a $120 million kickback lawsuit against North Cypress (Texas) Medical Center and its CEO, Robert A. Behar, M.D., claiming it paid kickbacks to physicians for patient referrals and used other improper billing techniques such as upcoding,
Increased funding for healthcare fraud and abuse oversight highlights a growing need for healthcare organizations to take a proactive approach to corporate compliance and risk assessment.
Applying pattern recognition software to multiple databases offers an efficient and frequently effective way for investigators to root our potential fraud.
The Department of Justice has requested information from Humana regarding risk adjustments assigned to Medicare Advantage beneficiaries, according to an annual report the insurance company filed to the Securities and Exchange Commission.
More than 2 million Americans were victims of medical identity theft in 2014, a 22 percent increase from the previous year, contributing to a gradual upward trend over the past five years, according to a study published by the Medicare Identity Fraud Alliance.
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Nina Pham contracted Ebola during the care she provided to Thomas Eric Duncan at Texas Health Presbyterian Hospital Dallas last year, and is now suing the parent company for the damaged she suffered.
A former employee Hospital Corporation of America, Inc., the large publicly-traded hospital operator, accused the organization of engaging in unnecessary surgeries in a whistleblower lawsuit, the Wall Street Journal has reported.