This week two of Advize Health’s own former HHS-OIG experts, Matt Kochanski and Wade McFaul presented a conversational webinar on Organized Fraud.

Matt and Wade discussed their experiences with the types of fraud and various ways they investigated these cases.  We heard both the similarity and unique differences between organized fraud schemes on the East Coast versus the West Coast. 

We heard examples of the evolution of fraud organizations as they moved from loose associations of providers and members to full blown criminal enterprises as individual providers organized themselves into illegitimate businesses, whether complicit or not.

The discussion included war stories from their respective careers from investigating P-Stim and wheelchair schemes to an individual actually chained up in an alley way at the hands of a shill DME company.

Some of the key focus areas for Matt and Wade included:

  • Definition of Organized Fraud
  • Types of Organized Fraud
    • Loose Assoc of Providers/Members
    • Centrally Controlled Business Model
    • Corporate Fraud
    • Criminal Enterprise
  • Examples of Organized Fraud
    • Past and Present
    • East Coast versus West Coast
  • How to Identify it

If you would like to view a recording of this session, it’s available on LinkedIn and the Advize YouTube channel.

By Dan Leslie