Posted and filed under Compliance, Fraud, Healthcare.

Fraud Spotlight: Fraud Fighters Love Data

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, there has been an unbelievable amount of bandwidth spent discussing telemedicine as…

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Fraud Spotlight: Time-Based Fraud 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. The past few days, I have spent time speaking to industry and government…

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Podcast: Medicare For All

Our very own Eric Rubenstein (Director of Litigation, Fraud, Waste, and Abuse Support) will be sitting down with progressive democrat Ron Rivers to discuss the divisive concept of Medicare For All in an upcoming podcast. Rivers will lead the discussion by exploring the social implications and infrastructure needed with such an expansion. Rubenstein will then…

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

Examining The Fraud Triangle

Federal healthcare fraud recoveries totaled upwards of $2.3B in the 2018 fiscal year. This staggering sum is proof enough that healthcare fraud is here to stay as an unfortunate reality of the industry. Providers, patients, and insurers alike have all been complicit in various scams and schemes – which brings to mind the question: why…

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Posted and filed under Fraud, Healthcare.

Fraud Spotlight: Compounding Pharmacy Fraud

Recently, the State of New Jersey, Division of Consumer Affairs (the department that administers, among other things, the Prescription Monitoring Program [PMP]), reclassified a drug known as Gabapentin.  In reclassifying the drug, it is now considered a scheduled drug in New Jersey, and must now be part of the PMP reporting. For those that do not…

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Posted and filed under Fraud, Healthcare.

Fraud Spotlight: The Unscrupulous Ophthalmologist

Over the last several weeks, I’ve been discussing some ways that unscrupulous providers take advantage of the system for their personal gain. But what about those underhanded providers who not only take advantage of the system itself, with things like services not rendered, medically unnecessary services, upcoding, and the slew of vernacular, but those same…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Hidden Dangers of a 1099

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 was recently speaking to a friend, who was describing a situation he…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Developing a Kickback Case

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. People continue to be amazed at the fact that healthcare providers are 1,…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: 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. People inherently trust their healthcare provider.  You go to your practitioner and expect…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Diagnostic Testing Done Wrong

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 keep up with the latest and greatest in…

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