Healthcare Fraud Cases Examples

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Nurse Practitioner Sentenced in Twelve Million Dollar Health Care …

(3 days ago) WEBPROVIDENCE, R.I. – A registered nurse and nurse practitioner, who defrauded commercial health insurers and Medicare of nearly $12 million by devising and executing fraudulent billing schemes in

https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/press-releases/nurse-practitioner-sentenced-twelve-million-dollar-health-care-fraud-scheme

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Serial Health Care Fraudster Sentenced for $234M Medicare Fraud …

(6 days ago) WEBAccording to court documents, Imran Shams, 65, of Glendale, was convicted of Medicare and Medicaid fraud in separate 1990 and 2001 cases in New York and …

https://www.justice.gov/opa/pr/serial-health-care-fraudster-sentenced-234m-medicare-fraud-scheme

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Justice Department Charges Dozens for $1.2 Billion in Health Care …

(3 days ago) WEB“HHS-OIG is proud to work alongside our law enforcement partners to disrupt fraud schemes that use the guise of telehealth to expand the reach of kickback …

https://www.justice.gov/opa/pr/justice-department-charges-dozens-12-billion-health-care-fraud

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Criminal Division Case Summaries - United States Department of …

(3 days ago) WEBJune 28, 2023. Summary of Criminal Charges. Central District of California. Neda Mehrabani, 47, of Tarzana, California, was charged by information with health …

https://www.justice.gov/criminal/criminal-fraud/health-care-fraud-unit/2023-national-hcf-case-summaries

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Four People Plead Guilty, Sentenced for Multi-Million-Dollar …

(5 days ago) WEBIn February, Satine pleaded guilty to felony Medicaid fraud and theft by deception and was sentenced to 1½ to 5 years in state prison. He is required to pay $2.8 …

https://www.attorneygeneral.gov/taking-action/four-people-plead-guilty-sentenced-for-multi-million-dollar-medicaid-fraud-scheme-that-involved-inflated-transportation-costs-other-phantom-services/

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Top Healthcare Fraud, Waste, and Abuse Takedowns of the Year

(Just Now) WEBJury returns indictment in $100M COVID-19 healthcare fraud case. In November 2021, a federal grand jury returned an indictment charging the owner of …

https://revcycleintelligence.com/features/top-healthcare-fraud-waste-and-abuse-takedowns-of-the-year

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Justice Department charges 78 in multibillion-dollar health care …

(Just Now) WEBA case out of the Southern District of Florida was among one of the largest health care fraud schemes ever prosecuted, agency officials said. The indictment …

https://www.npr.org/2023/06/28/1184795720/78-people-face-charges-for-2-5-billion-in-attempted-health-care-fraud-doj-says

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Health Care Fraud — FBI

(8 days ago) WEBHealth care fraud is not a victimless crime. It affects everyone and causes tens of billions of dollars in losses each year. The FBI is the primary agency for investigating health care fraud, for

https://www.fbi.gov/investigate/white-collar-crime/health-care-fraud

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Top Healthcare Fraud Takedowns of 2020

(6 days ago) WEBFeds charge 10 individuals in $1.4B rural hospital billing scheme. One of the largest healthcare fraud takedowns in 2020 involved charges against 10 individuals, including hospital managers, laboratory …

https://revcycleintelligence.com/news/top-healthcare-fraud-takedowns-of-2020

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Annual Report of the Departments of Healthand Human …

(4 days ago) WEBrevenues under the Health Care Fraud and Abuse Control Program for fiscal year 2020 is provided as required by Section 1817(k)(5) of the Social Security Act. The Social …

https://www.oig.hhs.gov/publications/docs/hcfac/FY2020-hcfac.pdf

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The Challenge of Health Care Fraud – NHCAA

(6 days ago) WEBEveryone Shares the Burden of Health Care Fraud. In 2018, $3.6 trillion was spent on health care in the United States, representing billions in health insurance claims. It is an …

https://www.nhcaa.org/tools-insights/about-health-care-fraud/the-challenge-of-health-care-fraud/

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8 Frightening Healthcare Fraud Examples in Real Life - Etactics

(1 days ago) WEBMedical Identity Theft Example 1. In September of 2021, a Las Vegas resident received 144 months in federal prison and a $4,321,590.39 fine for conspiring …

https://etactics.com/blog/healthcare-fraud-examples

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US announces charges in $2.5 billion healthcare fraud takedown

(9 days ago) WEBThe U.S. Justice Department on Wednesday announced federal and local criminal charges targeting 78 defendants across 16 states as part of a law enforcement …

https://www.reuters.com/legal/us-announces-charges-25-billion-healthcare-fraud-takedown-2023-06-28/

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Common Types of Health Care Fraud Fact Sheet - Centers for …

(Just Now) WEBThis fact sheet provides a brief overview of some common types of Medicaid fraud, waste, and abuse involving providers. Although the examples involve violation of Federal laws, …

https://www.cms.gov/files/document/overviewfwacommonfraudtypesfactsheet072616pdf

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2020 National Health Care Fraud and Opioid Takedown

(3 days ago) WEBCases Charged in Health Care Fraud and ARPO Strike Force Locations. For example, in one case, a telemedicine doctor who was the top prescriber in the …

https://www.justice.gov/criminal/criminal-fraud/hcf-2020-takedown/case-descriptions

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Health Care Fraud and Abuse Johns Hopkins Medicine

(7 days ago) WEBReport lost or stolen prescription pads and/or fraudulent prescriptions; and. Report all suspicions of fraud by contacting the Johns Hopkins Health Plans Special Investigations …

https://www.hopkinsmedicine.org/johns-hopkins-health-plans/providers-physicians/health-care-fraud-and-abuse

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Health care fraud: Ex-Bergen jail guard admits participating in …

(5 days ago) WEBFormer Bergen jail guard admits to helping defraud county health care system of $3 million. A former Bergen County corrections officer admitted in federal …

https://www.northjersey.com/story/news/bergen/2021/04/21/bergen-county-corrections-officer-admits-defrauding-county-healthcare-system/7325076002/

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Combating Health Care Fraud and Abuse: Conceptualization and

(3 days ago) WEBHealth care fraud and abuse involve all sectors of the health care industry, including drug and device manufacturers, hospitals, pharmacies, physicians, …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516680/

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Medicare and Medicaid fraudsters continue to steal taxpayer money

(1 days ago) WEBFiscal year 2023 proved to be a high value one for healthcare frauds and settlements, with the DOJ totaling $2 billion dollars in illicit activity. The U.S. Department …

https://www.thomsonreuters.com/en-us/posts/investigation-fraud-and-risk/medicare-medicaid-fraud-2024/

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Whistleblowers and Medical Fraud: A Book Review

(8 days ago) WEBIn medicine, whistleblowers face institutional denial, stonewalling, retaliation, and other kinds of reprisal. They expose coercive recruitment practices, conflicts of …

https://www.psychologytoday.com/intl/blog/side-effects/202405/whistleblowers-and-medical-fraud-a-book-review

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Arizona AG reveals 4 new indictments in AHCCCS fraud scandal

(4 days ago) WEBGovernment records revealed, according to the news release, that the health care facility billed AHCCCS and the American Indian Health Program for more than …

https://www.azcentral.com/story/news/local/arizona/2023/10/18/kris-mayes-announces-new-ahcccs-fraud-indictments/71228725007/

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Private equity in health care: three takeaways going forward

(9 days ago) WEBThree takeaways are: (1) Health care reimbursement is finite. The goal of short-term investments in providers that depend on third party reimbursement is a hard …

https://www.reuters.com/legal/litigation/private-equity-health-care-three-takeaways-going-forward-2024-05-09/

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42 CFR 438 Subpart H - Medicaid.gov

(5 days ago) WEBBackground. On May 6, 2016, CMS published the 2016 Managed Care Final Rule that included important program integrity safeguards in Part 438, Subpart H …

https://www.medicaid.gov/medicaid/program-integrity/download/managed-care-fraud-ref-toolkit.pdf

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The Major Supreme Court Cases of 2024 - The New York Times

(5 days ago) WEBThe Major Supreme Court Cases of 2024. By Adam Liptak , Abbie VanSickle and Alicia Parlapiano. May 9, 2024. No Supreme Court term in recent memory has …

https://www.nytimes.com/interactive/2024/05/09/us/supreme-court-major-cases-2024.html

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Office of Public Affairs National Health Care Fraud Enforcement

(8 days ago) WEBThe Department of Justice announced today criminal charges against 138 defendants, including 42 doctors, nurses, and other licensed medical professionals, in …

https://www.justice.gov/opa/pr/national-health-care-fraud-enforcement-action-results-charges-involving-over-14-billion

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The Benefits of AI in Healthcare IBM

(7 days ago) WEBFraud prevention: Fraud in the healthcare industry is enormous, at $380 billion/year, and raises the cost of consumers’ medical premiums and out-of-pocket …

https://www.ibm.com/think/insights/ai-healthcare-benefits

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Cancer care in Alberta is strained, under-resourced, medical

(9 days ago) WEBCancer cases expected to rise. This comes during a population boom for Alberta — more than 202,000 people came to the province last year alone. The AMA …

https://toronto.citynews.ca/2024/05/17/alberta-medical-association-cancer-care/

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10 Best AI Use Cases in Everyday Life - dorik.com

(Just Now) WEBIn this article, we will explore 10 AI use cases. We'll see how it's changing things like business, art, healthcare, and how we get around. Let's dive in and see how …

https://dorik.com/blog/best-ai-use-cases

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Medicaid Program; Ensuring Access to Medicaid Services

(7 days ago) WEBStrategies to enhance access to health care services should reflect how people move through and interact with the health care system. Medicaid coverage of …

https://www.federalregister.gov/documents/2024/05/10/2024-08363/medicaid-program-ensuring-access-to-medicaid-services

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Doctor And Three Others In Bergen County Charged In $10 Million …

(6 days ago) WEBAccording to documents filed in this case and statements made in court: The count of conspiracy to commit health care fraud is punishable by a maximum of 10 …

https://www.justice.gov/usao-nj/pr/doctor-and-three-others-bergen-county-charged-10-million-health-care-fraud-scheme

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Bob Menendez trial: Expect some NJ flavor in indictments - Bergen …

(1 days ago) WEBMenendez has said he is innocent of all the charges. The case will bring focus to the growing push by foreign countries to peddle influence in Washington by enlisting …

https://www.northjersey.com/story/opinion/columnists/charles-stile/2024/05/16/bob-menendez-trial-nj-flavor-indictments-gold-bars/73705876007/

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Clarifying the Eligibility of Deferred Action for Childhood Arrivals

(Just Now) WEBStart Preamble Start Printed Page 39392 AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS). ACTION: …

https://www.federalregister.gov/documents/2024/05/08/2024-09661/clarifying-the-eligibility-of-deferred-action-for-childhood-arrivals-daca-recipients-and-certain

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2021 National Health Care Fraud Enforcement Action

(8 days ago) WEBThe largest amount of alleged fraud loss charged in connection with the cases announced today – over $1.1 billion in allegedly false and fraudulent claims …

https://www.justice.gov/criminal/criminal-fraud/2021-national-health-care-fraud-enforcement-action

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USDA, HHS Announce New Actions to Reduce Impact and Spread …

(2 days ago) WEBOn March 25, 2024, immediately following the first detection of H5N1 in dairy cattle in the Texas panhandle region, USDA and HHS began their work to understand the origin of …

https://www.usda.gov/media/press-releases/2024/05/10/usda-hhs-announce-new-actions-reduce-impact-and-spread-h5n1

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District of New Jersey Announces Charges in Health Care Fraud …

(4 days ago) WEBAndrew McCubbins, 39, of Draper, Utah, the owner of a telemedicine company, pleaded guilty by videoconference on Sept. 24, 2020, before U.S. District …

https://www.justice.gov/usao-nj/pr/district-new-jersey-announces-charges-health-care-fraud-cases-part-nationwide-federal-law

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