Posted and filed under Community, FWA, Healthcare.

New Year. New Decade. Same Old Healthcare Story.

A message from our Managing Director, Jeanmarie Loria. Good afternoon friends, and Happy New Year. I wish you and your loved ones all the best this year and decade. When I was a kid, my New Year’s tradition was to watch the Twilight Zone with my family. Now, that tradition has evolved into me watching…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: The Truth About 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. With the New Year, comes more of the usual news about unscrupulous providers…

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Posted and filed under Coding, Fraud, FWA, Healthcare, Medical Record Auditing.

Fraud Spotlight: Economic Healthcare Fraud Perspectives

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, while having lunch with a friend who knew about my…

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

Fraud Spotlight: Prevention Through Medicare Literacy

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 the New Year will come an increase in Medicare premiums for those…

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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…

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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…

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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…

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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…

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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,…

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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…

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