Posted and filed under Compliance, Fraud, FWA, Healthcare.

Fraud Spotlight: Self-Disclosure Protocol

Retired OIG Special Agent and Advize’s Director of Litigation & FWA Support will be stepping in each week to examine current fraud trends from the lens of an investigator. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. I am surprised sometimes at the number of people in the healthcare field…

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Posted and filed under Compliance, Fraud, FWA, Healthcare.

Examining The Fraud Triangle

Federal healthcare fraud recoveries totaled upwards of $2.3B in the 2018 fiscal year. This staggering sum is proof enough that healthcare fraud is here to stay as an unfortunate reality of the industry. Providers, patients, and insurers alike have all been complicit in various scams and schemes – which brings to mind the question: why…

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Posted and filed under Fraud, Healthcare.

Fraud Spotlight: Compounding Pharmacy Fraud

Recently, the State of New Jersey, Division of Consumer Affairs (the department that administers, among other things, the Prescription Monitoring Program [PMP]), reclassified a drug known as Gabapentin.  In reclassifying the drug, it is now considered a scheduled drug in New Jersey, and must now be part of the PMP reporting. For those that do not…

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Posted and filed under Community, Healthcare.

5 Ways to Have a Better Day

As a part of our YogAuditing initiative, Advize Health has brought on board two yoga instructors dedicated to the practice and its principles. Designed to enrich life and improve work performance, YogAuditing is a movement to inspire movement. Follow the journey with us by subscribing to our newsletter, reading our blogs, tuning in to our…

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Posted and filed under Fraud, Healthcare.

Fraud Spotlight: The Unscrupulous Ophthalmologist

Over the last several weeks, I’ve been discussing some ways that unscrupulous providers take advantage of the system for their personal gain. But what about those underhanded providers who not only take advantage of the system itself, with things like services not rendered, medically unnecessary services, upcoding, and the slew of vernacular, but those same…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Hidden Dangers of a 1099

Retired OIG Special Agent and Advize’s Director of Litigation & FWA Support will be stepping in each week to examine current fraud trends from the lens of an investigator. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. I was recently speaking to a friend, who was describing a situation he…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Telehealth & Telemedicine

Retired OIG Special Agent and Advize’s Director of Litigation & FWA Support will be stepping in each week to examine current fraud trends from the lens of an investigator. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. The topic of telemedicine and telehealth has been a very hot topic in…

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Posted and filed under Healthcare.

Can In-Basket Messaging Prevent Burnout?

We’ve spoken before about physician burnout and how to leverage technology to reduce its impact on providers and patients, and now a study by Health Affairs has been released that supports this push for innovation. The study was designed to find strategies on managing in-basket messages, and how these messages can improve frontline clinical staff…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Unconventional Kickbacks

Retired OIG Special Agent and Advize’s Director of Litigation & FWA Support will be stepping in each week to examine current fraud trends from the lens of an investigator. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. In my blog posts the past few weeks, I discussed those instances when…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Developing a Kickback Case

Retired OIG Special Agent and Advize’s Director of Litigation & FWA Support will be stepping in each week to examine current fraud trends from the lens of an investigator. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. People continue to be amazed at the fact that healthcare providers are 1,…

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