Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: What We Can Learn From The Novartis Settlement

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. If you are keeping a scorecard on healthcare fraud prosecutions and settlements, you undoubtedly saw that…

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

Fraud Spotlight: How Crises Can Impact Fraud Investigations

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. Hurricane Katrina and COVID-19, what do these two very different things have in…

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

Fraud Spotlight: Compliance & The Reluctant Provider

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 compliance professional hopes that their employer buys into the suggestions, recommendations and…

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

Fraud Spotlight: The Use & Abuse of Modifier 25

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.  Modifier 25.  It has been the bane of existence for fraud, waste and…

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

Fraud Spotlight: Providers & Deferred Prosecution Agreements

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 few weeks, I have been discussing the investigative process.  From…

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

Fraud Spotlight: Subpoenas, Complaints, & Indictments

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, I discussed the different types of investigations that…

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

The 3 Ws of USDHHS OIG OI

Peggy Glynn, a former OIG Field Agent returns in this week’s guest blog post. Her friendship, insights, and experiences in the OIG are incredible tools for those looking to learn more about fighting healthcare fraud, waste, and abuse. What is the USDHHS? Who is the OIG? Why do you care about the OI? What: USDHHS…

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

Fraud Spotlight: Types of Healthcare Fraud Cases

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, I discussed the three main types of subpoenas that are typically…

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