Healthcare Fraud Investigative Plan

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CARESOURCE ANTI-FRAUD PLAN

(9 days ago) WEBFacilitate the identification and investigation of fraud . 1.0 INTRODUCTION . CareSource understands the profound financial and personal effect healthcare fraud, waste and …

https://www.caresource.com/documents/in-sp-0033-2018-anti-fraud-plan/

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PLANNING AND CONDUCTING A FRAUD …

(3 days ago) WEBInvestigation Planning and Conducting a Fraud Examination Fraud Examiners Manual: 2022 Edition 3.101 PLANNING AND CONDUCTING A FRAUD EXAMINATION Fraud …

https://www.acfe.com/-/media/images/acfe/products/publication/fraud-examiners-manual/2022_fem_sample_chapter.ashx

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Criminal Division Health Care Fraud Unit - United States …

(Just Now) WEBPoints of Contact to Report Health Care Fraud: Health and Human Services Office of Inspector General (“HHS-OIG”): HHS-OIG fights waste, fraud, and …

https://www.justice.gov/criminal/criminal-fraud/health-care-fraud-unit

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The Health Care Fraud and Abuse Control Program …

(1 days ago) WEBHealth Care Fraud Prevention Partnership (HFPP): The Obama Administration has joined with private insurers, states, and associations in the HFPP to …

https://www.cms.gov/newsroom/fact-sheets/health-care-fraud-and-abuse-control-program-protects-consumers-and-taxpayers-combating-health-care-0

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Health Care Fraud — FBI

(8 days ago) WEBMissouri and New Orleans Men Charged with $174 Million Conspiracy to Commit Health Care Fraud. 05.10.2024. Connecticut Ophthalmologist Sentenced to Prison for Five-Year Health Care Fraud Scheme

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

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Fraud, Waste, and Abuse - Centers for Medicare

(5 days ago) WEBDepartment of Justice (DOJ) Criminal Division Fraud Section’s Health Care Fraud Unit in September 2020 identifying $4.5 billion in allegedly false and healthcare fraud …

https://www.cms.gov/files/document/hfpp-white-paper-healthcare-fraud-waste-and-abuse-context-covid-19.pdf

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Annual Report of the Departments of Healthand Human …

(4 days ago) WEBAlso, in FY 2020, DOJ opened 1,079 new civil health care fraud investigations and had 1,498 civil health care fraud matters pending at the end of the fiscal year. Federal …

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

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2020 National Health Care Fraud Takedown Office of Inspector …

(8 days ago) WEBThe Department of Health and Human Services Office of Inspector General, along with our state and federal law enforcement partners, participated in a health care …

https://oig.hhs.gov/newsroom/media-materials/2020takedown/

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

(3 days ago) WEBPrior to the charges announced as part of today’s nationwide enforcement action and since its inception in March 2007, the Health Care Fraud Strike Force, which …

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

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Annual Report of the Departments of Health and Human …

(Just Now) WEBAlso, in FY 2021, DOJ opened 805 new civil health care fraud investigations and had 1,432 civil health care fraud matters pending at the end of the fiscal year. Federal …

https://oig.hhs.gov/publications/docs/hcfac/FY2021-hcfac.pdf

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Fraud and Abuse Investigations Handbook for the Health Care …

(2 days ago) WEBAHLA Health Plans Contracting Handbook, Eighth Edition Ambulatory Surgery Centers: Legal and Regulatory Issues, Sixth Edition A new chapter on the collateral …

https://www.americanhealthlaw.org/getmedia/dda37af5-3b37-4865-abc2-0535503232ff/FA_Invest_LookInside.pdf?_hsenc=p2ANqtz-_ggH2JH1Yfv46jdo4v-tV5YvmXRXsRuvyhJ8kaYlIOGwQ_k7oHihbvNgRRC6Mm9dmCWGnfe3-fB84pWqSzR4ZE8j5g8A

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Health Care Anti-Fraud Associate (HCAFA) Designation - AHIP

(4 days ago) WEBIndustry professionals at every level are challenged every day with detecting and stopping health care fraud. By earning your Health Care Anti-Fraud Associate (HCAFA) …

https://www.ahip.org/designations/health-care-anti-fraud-associate-hcafa-designation

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Health Care Fraud Cigna Healthcare

(8 days ago) WEBHow to Report Health Care Fraud. Call the Special Investigations hotline at 1 (800) 667-7145. Email us: [email protected]. Write to us: Cigna Healthcare …

https://www.cigna.com/legal/members/report-fraud

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Healthcare Fraud: A World Beyond the Anti-Kickback Statute

(8 days ago) WEBTraditionally, the Anti-Kickback Statute (42 U.S.C. § 1320a-7b)—alone or in conjunction with the Federal False Claims Act (31 U.S.C. § 3729 et seq. )—has been the …

https://www.jdsupra.com/legalnews/healthcare-fraud-a-world-beyond-the-5156658/

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District of New Jersey Announces Charges in Health Care Fraud …

(4 days ago) WEBThe charge of conspiracy to commit health care fraud is punishable by a maximum potential penalty of 10 years in prison and a fine of $250,000, or twice the …

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

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Unraveling Healthcare Fraud: Exploring ROI and Deterrence …

(2 days ago) WEBIn the ongoing battle against healthcare fraud, understanding the effectiveness of anti-fraud efforts is paramount. This Q&A, featuring Questrom Assistant …

https://insights.bu.edu/unraveling-healthcare-fraud-exploring-roi-and-deterrence-challenges/

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Boot Camp for the Health Care Fraud Investigator – Virtual Program

(4 days ago) WEBExplain common health care fraud schemes. Implement basic investigative strategies to enhance fraud detection and investigation. Identify the steps in an investigative plan. …

https://www.nhcaa.org/events/boot-camp-for-the-health-care-fraud-investigator-virtual-program/

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Connecticut ophthalmologist sentenced to prison for five-year …

(Just Now) WEBAssistant U.S. Attorney Howard Locker of the Health Care Fraud Unit prosecuted the case. CI is the criminal investigative arm of the IRS, responsible for …

https://www.irs.gov/compliance/criminal-investigation/connecticut-ophthalmologist-sentenced-to-prison-for-five-year-health-care-fraud-scheme

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Bergen NJ counseling center owner admits health care fraud

(7 days ago) WEBThe owner of a New Jersey counseling center admitted to her role in a health care fraud scheme involving hundreds of false claims, U.S. Attorney Philip R. …

https://www.northjersey.com/story/news/bergen/garfield/2024/03/19/bergen-county-nj-counseling-center-owner-health-care-fraud/73033753007/

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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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WHO’s Investigations and Studies (Unity Studies): a standardized

(5 days ago) WEBWHO’s Investigations and Studies (Unity Studies) provides the systems, tools and connections to carry out enhanced surveillance and targeted investigations and …

https://www.who.int/news/item/16-05-2024-who-s-investigations-and-studies-a-standardized-preparedness-framework-for-an-effective-and-proportionate-response

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CHP employee and 14 others charged in complex insurance fraud …

(7 days ago) WEBThe San Bernardino County District Attorney's Office charged all 15 suspects with insurance fraud, grand theft by trick and false imprisonment. Law …

https://www.cbsnews.com/losangeles/news/chp-employee-and-14-others-charged-in-complex-insurance-fraud-ring/

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Medical Equipment Suppliers Convicted of Health Care Fraud

(6 days ago) WEBThe Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this …

https://www.justice.gov/opa/pr/medical-equipment-suppliers-convicted-health-care-fraud

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Ex-NBA player Glen 'Big Baby' Davis sentenced to 40 months in …

(1 days ago) WEBScooby Axson. USA TODAY. 0:04. 1:31. Former NBA player Glen "Big Baby" Davis was sentenced to 40 months in prison on Thursday for defrauding the league's …

https://www.usatoday.com/story/sports/nba/2024/05/09/glen-big-baby-davis-prison-sentence-defraud-nba-healthcare-scheme/73629712007/

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Ex-NBA player Glen Davis sentenced to 40 months in prison over

(9 days ago) WEBMay 9, 2024. Former NBA player Glen Davis was sentenced to 40 months in prison for his role in defrauding the NBA Players’ Health and Benefit Welfare Plan, according to …

https://www.nytimes.com/athletic/5483054/2024/05/09/glen-davis-prison-sentence-fraud-nba/

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Boot Camp for Health Care Fraud Investigators and Analysts

(8 days ago) WEBExplain common health care fraud schemes. Implement basic investigative strategies to enhance fraud detection and investigation. Identify the steps in an …

https://www.nhcaa.org/events/boot-camp-for-health-care-fraud-investigators-and-analysts/

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Steward Health Files Chapter 11 After Medical Properties Deal

(2 days ago) WEBIn January, Medical Properties provided Steward Health with a $60 million bridge loan and deferred some of its rent arrears. Medical Properties fell as much as …

https://www.bloomberg.com/news/articles/2024-05-06/steward-health-files-chapter-11-after-medical-properties-deal

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Glen 'Big Baby' Davis sentenced to 40 months in prison over fraud

(4 days ago) WEBNBA coaching carousel: Latest on Lakers and Wizards search. Glen "Big Baby" Davis was sentenced by a federal judge to 40 months in prison for his conviction …

https://www.espn.com/nba/story/_/id/40113791/glen-big-baby-davis-sentenced-40-months-prison-fraud-scheme

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Doctor Convicted of $6.3M Medicare Fraud Scheme

(3 days ago) WEBThe Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, …

https://www.justice.gov/opa/pr/doctor-convicted-63m-medicare-fraud-scheme

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Glen Davis: NBA champion sentenced to 40 months in prison for

(8 days ago) WEBFormer NBA champion Glen Davis has been sentenced to 40 months in prison for his part in a scheme to defraud the league’s health care plan out of millions of …

https://www.cnn.com/2024/05/10/sport/glen-davis-sentenced-prison-defraud-nba-health-plan-spt-intl/index.html

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Ex-NBA Player Glen ‘Big Baby’ Davis Gets 40 Months for Fraud

(9 days ago) WEBMay 9, 2024 at 1:10 PM PDT. Listen. 1:37. Former National Basketball Association player Glen “Big Baby” Davis was ordered to spend more than three years behind bars for …

https://www.bloomberg.com/news/articles/2024-05-09/ex-nba-player-glen-big-baby-davis-gets-40-months-for-fraud

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

(1 days ago) WEBA very Jersey flavor. But Menendez's trial, which is expected to last six to seven weeks, will also have a distinctly Jersey focus. Prosecutors, for example, allege …

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

(6 days ago) WEBThe count of conspiracy to commit health care fraud is punishable by a maximum of 10 years in prison; the count of violating the federal anti-kickback statute is …

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

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