Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: The Curious Case of EOB/EOMB

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. Explanation of Benefits (EOB). Explanation of Medicare Benefits (EOMB). For those of you…

Read the full article

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

Fraud Spotlight: Another Ophthalmologist Fraud Bust

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. This past week, the US Attorney’s Office in the Southern District of NY…

Read the full article

Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Human vs Machine

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. This past week I attended a CMS “listening session” hosted by the Center…

Read the full article

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

Fraud Spotlight: Provider Awareness & Compliant Billing

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. This past week, I had the pleasure of presenting a webinar to approximately…

Read the full article

Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Specific Deterrence

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. As some of you may have seen in a LinkedIn post I wrote,…

Read the full article

Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: The Mission of CMS & The OIG

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. Last week, the CMS Administrator made some comments that outlined some new initiatives…

Read the full article

Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Conviction, Sentencing, & Justice

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. Several weeks ago, I wrote about cases involving multiple defendants, and how people…

Read the full article

Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: CVS/Caremark Network Agreement

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. For those of you who are more involved in the fraud, waste, abuse…

Read the full article

Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Investigating BLS Transports

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. My blog on basic life support (BLS) ambulance transports triggered a lot of…

Read the full article

Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: The Role of Training & Education

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. Training and education.  We in the fraud, waste and abuse world just can’t…

Read the full article