Posted and filed under Fraud, Healthcare, Payers.

High Cost of Healthcare: When Treatment Goes Wrong

Should a patient who suffers a medical condition as a result of their treatment have to pay for the resulting treatment? Should the financial responsibility go to their insurance or the facility that caused the problem? Before everyone starts hitting the comment button and mentioning hospital-acquired conditions, let us set the stage for the scenario:…

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Posted and filed under Dental, Fraud, FWA, Uncategorized.

Rinse & Spit: Investigating Dental Fraud

Next Week On The Blog: Jeanmarie Loria sits down with her partner Eric Rubenstein, retired OIG Agent, to ask him why he had more cases on pharmacy pain management and DME than dental fraud.  Dental fraud stinks worse than the most severe case of halitosis.    Picture this.   Brooklyn NY 1960. All 5 of…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Examining The Audacity & Prosecution of Fraudsters

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. We here at Advize are always monitoring the press releases that are coming out of the…

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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.

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 Compliance, Fraud, FWA.

Profiting Off Of COVID-19? You Better Be Documenting.

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 couple of weeks, I have seen an unbelievable number of…

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Posted and filed under Compliance, 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: Advance Directives Prevent Healthcare Fraud

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’m going to preface this by saying what I’m about to write about…

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