CMS Needs to Fully Align Its Antifraud Efforts with the Fraud Risk Framework
(Source – www.gao.gov) The approach that the Centers for Medicare & Medicaid Services (CMS) has taken for managing fraud risks
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Medicare Fraud; Illegal Activities
Whistleblower: Medicaid Managed-Care Firm Improperly Denied Care To Thousands
(By Chad Terhune for California Healthline produced by Kaiser Health News) In early October, an executive at one of the
Read MoreDoctors Make Big Money Testing Urine For Drugs, Then Ignore Abnormal Results
(By Fred Schulte for Kaiser Health News) In April 2014, state and federal drug agents raided Jeffrey Campbell’s medical clinic
Read MoreA $63 million health insurance scam
According to the U.S. Department of Justice, a group coordinated criminal defendants in the Miami-Dade state court system to execute
Read MoreMedicare Scams
In a telephone survey conducted in 2010, one fifth of Americans over 65 reported that they had been subject to
Read MoreImproper Payments Paid Out by Medicare is the Lowest since 2013
The Centers of Medicare and Medicaid Services (CMS) stated that the number of improper payments paid out by Medicare is
Read MoreMedicare Fraud Schemes Reaching as High as $200 Million
Medicare Fraud Strike Force along with Federal law enforcement officials around the country continue to crack down on provider Medicare
Read MoreScam Alert: You Do Not Pay for Your New Medicare Card!
The Federal Trade Commission (FTC) warns seniors to hang up if they receive calls from individuals claiming to be from
Read MoreMedicare Recouping Nearly $3 Billion in Capitation Payments on behalf of Deceased Beneficiaries
According to a federal audit, CMS was “generally effective” in making sure that Medicare capitation payments were not made on
Read MoreMedicare’s Fraud Audit is Undergoing a Major Overhaul
The Centers of Medicare and Medicaid Services plans to implement a new audit strategy in which Medicare administrative contractors, or
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