OIG Files: Weekly Round-Up

OIG Files: Weekly Round-Up

This week’s round up from Eric Rubenstein, our very own Sr. Director of FWA and Litigation. Pharmacist Convicted for Health Care Fraud and Black-Market Prescription Drug Diversion Scheme This case comes right out of our very own Wade McFaul’s old...
OIG Files: Fraud is Always in Fashion

OIG Files: Fraud is Always in Fashion

We are proud to bring a new fashion of fraud your way.  You might ask yourself, what is the difference between Vintage, Antique, and Retro?  Let’s start here, vintage is something that is too old to be considered used and is often related to past pop culture, junk...
OIG Files: Open (Enrollment) Season on Fraud

OIG Files: Open (Enrollment) Season on Fraud

Open enrollment will be upon us in the coming month.  With it will come a slew of fraud complaints as it relates to managed care enrollment.  Brokers work to enroll eligible members into plans that are supposed to be the best suited for the member. ...
Eric Rubenstein’s Weekly Wrap Up (08/29-09/02)

Eric Rubenstein’s Weekly Wrap Up (08/29-09/02)

Boca Raton Chiropractor Sentenced To Four Years’ Imprisonment For $20 Million Health Care Fraud Scheme Straw ownership is a huge challenge in healthcare fraud investigations. The creation of shell companies and nominal owners obscures the true ownership and thus, the...
OIG Files: A Little Silver Lining

OIG Files: A Little Silver Lining

A phrase that does not often come up is “medical loss ratio,” or MLR.  As an OIG Agent, I spent very little time looking at the OIG Workplan (I’ve blogged and spoken about how OIG Agents follow the current frauds, and how the plan is very much used to direct the work...