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 Fraud, FWA, Healthcare, Medical Record Auditing.

Fraud Spotlight: The Kyphoplasty & The Qui Tam

This week’s Fraud Spotlight article was written by Peggy Glynn, a former OIG Field Agent from Buffalo, NY. Her friendship, insights, and experiences in the OIG are incredible tools for those looking to learn more about fighting healthcare fraud, waste, and abuse. Who is Kyphon Inc., what is a kyphoplasty, and where does the Civil…

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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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