Blog
Weekly Updates on Healthcare FWA, Insurance, Law & other (typically) Healthcare related shenanigans™.
The New “Most Dangerous Game”: How Artificial Intelligence is Changing the Landscape of Healthcare Fraud
In the short story “The Most Dangerous Game” by Richard Connell (and the movies based on the story), a big game hunter traps humans on an island...
Just the Facts, Ma’am: Navigating Healthcare Investigations with Precision
The biggest mistake a healthcare investigator can make is to forget what their mission is. It is not to solve a crime; it is to follow the facts...
Fraud Hunters: Keep Your Eyes Open – Peculiar Business Pairings in South Florida
On a recent trip to South Florida, I came across some very interesting sights that gave me pause. The first was the combination of an Adult Day...
Back From NAMPI: Insights into the Fight Against Medicaid Fraud
Scottsdale was hot AF (Hot As Fraud) – temperatures were way over 105, and hot Medicaid Fraud topics were discussed. The National Association for...
Uncovering the Troubling Reality of Improper Payments in COVID-19 Programs: People with Insurance got COVID Services Paid by HRSA?!! You Don’t Say?
There is absolutely nothing in this report that should be interesting, shocking, or otherwise reflective of surprise. $784 million in improper...
Drugs: Deal or No Deal
The only government program that I can think of that did not authorize price negotiations for prescription medications was the Medicare Part D...
Fraud Hunters: Expanding the Scope
Every investigator knows that keeping your focus on the allegation is the key to efficiently conducting your investigation. There are times,...
NJ Passes Legislation to Mirror Some Medicare Regulations
Extending some of the recent prescription caps and data transparency requirements under the new Medicare payment rules, NJ has followed suit to...
Fraud Hunters: Claim Determinations
Self doubt is a necessary part of the process when making claim determinations. As a reviewer, you have the ultimate decision-making authority as...
14,800+
Avid Subscribers
Sign up for our weekly newsletter and receive updates on Healthcare, FWA, Healthcare Law, Advize and more.