Most U.S. insurers measure the performance of special investigations units, but their methods for measuring SIU success vary, according to results from the Coalition Against Insurance Fraud's first-of-its-kind benchmarking study.
September is healthcare fraud awareness and prevention month, and that makes this a good time to acknowledge the work of Senior Medicare Patrols. SMPs are a national project run by states to teach citizens to prevent, detect and report Medicare and Medicaid fraud, error and abuse. The SMPs are a dynamic force for good. They show us that fraud isn't a crime we should passively accept. Read more...
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Michigan oncologist Farid Fata, M.D., awaiting trial for orchestrating a multi-million dollar Medicare fraud scheme, entered a surprise guilty plea yesterday to 13 counts of healthcare fraud, two counts of money laundering and one count of conspiracy to pay and receive kickbacks, the Detroit Free Press reported.
Good news for those who report wrong-doing by government contractors: Congress will draft legislation to shore up whistleblower protections, and an appeals court ruled that whistleblowers aren't necessarily required to cite specific examples of fraud.
Recent enforcement actions by the U.S. Department of Justice showcase federal efforts to put the kibosh on fraudulent claims filed with government programs for therapeutic services.
Senior scams aren't just about conning the elderly out of their life savings; there's also a connection between elder abuse and healthcare fraud.
Insider crime made news recently after current and former government workers pleaded guilty to committing healthcare fraud on the job.
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Sustainability is an important factor that must be considered when building health research and analytics data infrastructures. To that end, researchers say that factors to take into consideration include assets, expansion, complexity and stakeholders.