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

Fraud Spotlight: Understanding Medicare as a Secondary Payer (MSP)

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.  Recently, we discussed a situation where Medicare may still pay for a service, item or procedure…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: The Real Healthcare Fraud Profiteers

Healthcare fraud is a pervasive issue, we all know this. We write about its effects every week here at Advize Health, and thousands of our compatriots have dedicated their professional lives to put a stop to the issue – much to no avail. Sadly, it seems that healthcare fraud is here to stay. This is…

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

Fraud Spotlight: Medicare Beneficiaries

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 a blog post about a case that I…

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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 Fraud, FWA, Healthcare.

Fraud Spotlight: Unconventional 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. In my blog posts the past few weeks, I discussed those instances when…

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