Investigative Competence

Investigative Competence

I spent about 25 years in federal law enforcement, and most of that time was as a Senior Special Agent at HHS-OIG.  I loved working there, and I loved doing healthcare fraud investigations.  When I was exploring retirement, and what I was interested in doing...

OIG Files: Health Plans, Cherry Picking & Lemon Dropping

When I was first hired as an OIG Agent, I was told by numerous people that fraud in the Medicare Advantage (MA) world was difficult to commit, and ever more difficult to prove. To put it into context, it was the mid-1990s, and MA plans were not where they are...