Posted and filed under Compliance, FWA, Medical Record Auditing, Payers.

Fraud Spotlight: Document Now, Ace an Audit Later

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. Every day, we read another article or another news release about the ever-changing…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Telehealth & the Medicare Population

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. Over the past several weeks, we have seen unprecedented changes to rules, edits…

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Posted and filed under Fraud, FWA.

Fraud Spotlight: Chronic Care Management Fraud

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. Recently, I was speaking with a client regarding Chronic Care Management (CCM), and…

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Posted and filed under Community, Compliance, Fraud.

5 Common COVID-19 Fraud Schemes

Relaxed Doesn’t Mean Right …and it certainly doesn’t imply safe. First, we are seeing it with Cybersecurity. Then, we will see more leniency with HIPAA and FWA around the practices and procedures that are occurring. We have seen unprecedented allowances in the past two months. CMS is relaxing the rules, telehealth is being set up to work…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Provider Credentials, Fraud, & COVID-19

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 From a resource perspective, we as a nation, and those in the law…

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

Fraud Spotlight: Advance Directives Prevent Healthcare Fraud

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’m going to preface this by saying what I’m about to write about…

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

Fraud Spotlight: The Consequences of Relaxed Billing Regulations

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. Although I had strongly thought about not discussing anything COVID-19 related in this…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: COVID-19 Fraud Schemes & Paradigm Shifts

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. With every single social media post out there is about Coronavirus (and just…

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

Fraud Spotlight: Phantom Billing & Services Not Rendered Schemes

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. Two phrases that are common in the healthcare fraud world are: phantom billing…

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Posted and filed under Fraud, FWA, Healthcare.

COVID-19’s Impact on Telemedicine & Reimbursements

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. Under Medicare rules, telemedicine, or telehealth as it is also commonly known, required…

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