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AAPC NYC Regional Conference

Eric Rubenstein, Director of Litigation & FWA at Advize Health will be speaking at the AAPC’s New York City Regional Conference. His session, GS2:Anatomy of a Healthcare Fraud Investigation: Implications and Stop-Gap Measures for Compliance Professionals will provide attendees with information on the variety of ways in which an OIG healthcare fraud investigation is initiated….

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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: Telehealth & Telemedicine

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 topic of telemedicine and telehealth has been a very hot topic in…

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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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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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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Genetic Testing

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. Fraud. It is everywhere; mortgage applications and loans, credit cards, you name it….

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Posted and filed under Compliance, Healthcare.

OIG Medi-Cal Audit Reveals $70M in Incorrect Payments

Earlier this month, the Office of Inspector General released a 29-page audit report of an investigation conducted on the California Department of Health Care Services. The audit, which covered the review of more than 112,000 Medicaid capitation payments amounting to nearly $74 million dollars was initiated to determine whether California had made capitation payments on…

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