Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Detecting & Investigating FWA during COVID-19

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

Fraud Spotlight: Year in Review

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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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Understanding the OIG’s Key Operating Divisions

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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Posted and filed under Fraud, FWA, Healthcare.

Legal Violations Against Physical Therapists: Part I

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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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: The OIG, Speaker Programs & Kickbacks

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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Posted and filed under Coding, Fraud, FWA.

Fraud Spotlight: Providers & The “Impossible Day”

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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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Recidivism & Sentencing in Healthcare Fraud

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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Posted and filed under Dental, Fraud, FWA.

Dental Horror: A Case of Life of Death

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 rounds out lessons in dental misconduct involving fraudulent billing, medical records forgery/lack of documentation, and standard of care from a case in real…

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

Fraud Spotlight: Why Dental Fraud is Overlooked & Ignored

Over the past few weeks, we have been blogging and posting about the “red-headed step-child” of healthcare fraud, dental fraud. One of our retired OIG agents recently heard this tale, which bears repeating: At a recent visit, his mother was told by the treating dentist that she had a gum infection and needed to see…

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