Fraud Spotlight: Detecting & Investigating FWA during COVID-19

Posted by & filed under Fraud, FWA, Healthcare.

The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. We hopefully are seeing the beginning of the end with COVID-19, but we will certainly not see…

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Fraud Spotlight: Year in Review

Posted by & filed under Community, Fraud, FWA, Healthcare.

The year 2020 was ripe with unprecedented challenges. Between a global pandemic, civil unrest, and rampant socio-political uncertainty…there was a lot to deal with. The healthcare industry was thrust into the spotlight, first for its heroes on the frontlines, then for its billing practices. COVID-19 put medical documentation under a microscope, examining everything from cause…

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Fraud Spotlight: Understanding the OIG’s Key Operating Divisions

Posted by & filed under Fraud, FWA, Healthcare.

The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. When we speak to various people in our space looking to engage us in work that…

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Legal Violations Against Physical Therapists: Part II

Posted by & filed under Compliance, Fraud, FWA, Healthcare.

It’s more than money when your license is on the line.  This week’s Fraud Spotlight features guest contributor Mark R. Brengelman, JD, MA. Be sure to tune into the column for more expert insights from our network of providers, investigators, and fraud experts. This article continues a multi-part series that will be covering the top ten violations…

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3 Quick Tips to Avoid an Audit

Posted by & filed under Fraud, FWA, Healthcare, Medical Record Auditing.

Healthcare providers have a lot on their minds. Between daily rounds, patient care, and an ongoing global pandemic – it’s not easy to stay on top of administrative tasks like documentation and medical record maintenance. Even so, medical record review is a critical function of the healthcare ecosystem. The reality is that there are a lot…

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Legal Violations Against Physical Therapists: Part I

Posted by & filed under Fraud, FWA, Healthcare.

This week’s Fraud Spotlight features guest contributor Mark R. Brengelman, JD, MA. Be sure to tune into the column for more expert insights from our network of providers, investigators, and fraud experts. This article begins a multi-part series covering the top ten violations of law against physical therapists that are enforced by state licensure boards against these health care…

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Fraud Spotlight: The OIG, Speaker Programs & Kickbacks

Posted by & filed under Fraud, FWA, Healthcare.

The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. A couple of weeks ago, the OIG issued a Special Fraud Alert regarding the use of speaker…

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Fraud Spotlight: Providers & The “Impossible Day”

Posted by & filed under Coding, Fraud, FWA.

The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. When a provider commits healthcare fraud, and they hit all the “goodies,” we just have to…

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Fraud Spotlight: Recidivism & Sentencing in Healthcare Fraud

Posted by & filed under Fraud, FWA, Healthcare.

The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes.  Earlier in the week, this press release came out. We spent a lot of time looking through…

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