Pharmacy fraud cases brought to light across the country

December has been a month filled with pharmacy fraud arrests, convictions and court cases. Phramacy fraud activity and allegations involving repackaged drugs, alleged kickbacks, along with whistleblower award litigation, were reported in Ohio, Maryland, Michigan, Illinois and California.

Moda Health turns to automated fraud prevention to help protect members

As insurers look for ways to fight healthcare fraud and identity theft, one insurance company is turning to automated alert system to offer real time identity theft monitoring and fraud resolution for its beneficiaries. That's why Moda Health is incorporating an alert system developed by ID Experts into its plans as a way to help members identify false claims.

Florida managed care company seized by state loses shot at redemption

Remember Florida Healthcare Plus, the managed care company that looked like it had a shot at redemption following an FBI raid and fraud arrests? Turns out that won't be the case.

Final healthcare worker sentenced in nation's largest mental health scam

Miami certified nursing assistant Rodolfo Santaya, 55, was sentenced to more than 12 years in prison for his involvement in the largest mental health scam in U.S. history. The scheme totaled nearly $200 million in fraudulent Medicare payments.

Lawmakers call for SSA to do more to prevent physician-assisted fraud

Senate Finance Committee Ranking Member Orrin Hatch (R-Utah) and House Ways and Means Subcommittee on Social Security Chairman Sam Johnson (R-Texas) have calld out the discrepancies between Medicare fraud prevention efforts and the lack thereof at the Social Security Administration.


From Our Sister Sites


There's no room for doubt that the healthcare industry needs to improve patient safety, Robert Wachter, M.D., told the audience at the Institute for Healthcare Improvement's recent forum on the issue--and he has a few ideas about how to go about it.


At a time when standalone hospitals feel pus hed to form alliances to survive, one California provider has thrived without sacrificing its independence, accord ing to   MedCity News.