"After 11 months of largely sitting alone in his room undergoing what the hospital called "Chair Therapy" (sit and think about your life) he left...
OIG Files Articles
Money Isn’t Everything but the Audits and Investigations are Free
We work very closely in the payor and provider space to ensure that fraud, waste, abuse (FWA) and compliance are at the forefront of the payment...
MA and Risk-Scoring, We Can Do Better (and Advize does)
When you first open this article, the most glaring of things is the time frame from which the audit was derived. 2011-2013 data is at this point...
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...
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...
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...
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...
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...
OIG Files: Vignettes of the Week
If you missed Eric opining on LinkedIn this week, here are some quick pieces of information including: an infectious disease doctor, a case in NJ,...
OIG Files: Go Your Own Way
While CMS reported that is collected half of the overpayments previously identified by OIG, the OIG in another recent review (full report) found...
Inefficacy is a 10 Letter Word for Nonsense
I recently needed to get a CT scan done as part of a full physical examination. The ordering doctor and the imaging center are associated...
Don’t Ride the Carousel
In some of my recent posts, I have mentioned the term "carouselling," as it pertains to the recycling of diabetic testing supplies. I have had...
12,200+
Avid Subscribers
Sign up for our weekly newsletter and receive updates on Healthcare, FWA, Healthcare Law, Advize and more.