There are resources available to help prevent wrongdoers from successfully targeting vulnerable patient populations. A dirty little secret of the long-term care industry is that the problem of identity theft arises more often than is reported.  In all fraud, there is the fraud triangle. The triangle sides are pressure, opportunity,…
More than 700 pages of text make up proposed changes to the federal Stark and anti-kickback statutes. On Wednesday, Oct. 9, federal healthcare officials announced two new proposed rules.  While the main focus of both proposals is to remove perceived legal barriers to various value-based reimbursement models and facilitate care…
Conspiracy ran for nearly 20 years, netting owner of assisted living and skilled nursing facilities $37 million. The primary orchestrator of what federal authorities called the most wide-reaching healthcare fraud scheme ever uncovered has been sentenced to 20 years in state prison – far short of the 30 years prosecutors…
Recent report from HHH/OIG faults CMS. A recent study by the U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) revealed a concerning series of findings related to the under-reporting of instances of potential abuse and/or neglect of elderly Medicare patients. Every year, tens of thousands…
OIG’s report to Congress profiles plenty of activity, including the ongoing battle against the opioid abuse epidemic. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) is in the business of rooting out “fraud, waste, and abuse” in the nation’s healthcare system, to echo the…
Most of those accused of wrongdoing are medical professionals. The national opioid crisis has hit the heart of Appalachia particularly hard, and federal authorities are pulling out the stops in fighting it. U.S. Attorney General William P. Barr and U.S. Department of Health and Human Services (HHS) Secretary Alex M.…
Two dozen individuals were charged in a landmark investigation historic in breadth. “A million dollars isn’t cool,” remarked pop star Justin Timberlake in the Oscar-winning 2010 film The Social Network, portraying entrepreneur Sean Parker as he advises a young Mark Zuckerberg and his associates in a nightclub amid the fledgling…
The head of the federal healthcare oversight body was a popular guest on Monitor Mondays. Daniel Levinson, Inspector General of the U.S. Department of Health and Human Services (HHS), is stepping down from his post at the end of May, following nearly 15 years in his position as healthcare’s top…
The federal watchdog did not, however, decide to demand recoupments. It is said that great minds think alike. And that proved to be true when the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) released its report (CMS improperly paid millions of dollars…
Hiring a consultant can be a high-risk activity.  Don’t get me wrong; I am definitely not disparaging consultants in general. A good consultant can get you out of a jam. I regularly rely on the wisdom of consultants, including my fellow RACmonitor authors and Monitor Mondays panelists, while assisting clients. But as…
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