Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Medicare Beneficiaries

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. Several weeks ago, I wrote a blog post about a case that I…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: What About the “Other” Guys?

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. As some of you who follow healthcare fraud have likely read, the CEO…

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Posted and filed under Compliance, Fraud, Healthcare.

Fraud Spotlight: Fraud Fighters Love Data

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. Recently, there has been an unbelievable amount of bandwidth spent discussing telemedicine as…

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Posted and filed under Uncategorized.

Fraud Spotlight: Time-Based Fraud Schemes

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. The past few days, I have spent time speaking to industry and government…

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Posted and filed under Compliance, Fraud, FWA, Healthcare.

Fraud Spotlight: Self-Disclosure Protocol

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 am surprised sometimes at the number of people in the healthcare field…

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Posted and filed under Fraud, Healthcare.

Fraud Spotlight: Compounding Pharmacy Fraud

Recently, the State of New Jersey, Division of Consumer Affairs (the department that administers, among other things, the Prescription Monitoring Program [PMP]), reclassified a drug known as Gabapentin.  In reclassifying the drug, it is now considered a scheduled drug in New Jersey, and must now be part of the PMP reporting. For those that do not…

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Posted and filed under Fraud, Healthcare.

Fraud Spotlight: The Unscrupulous Ophthalmologist

Over the last several weeks, I’ve been discussing some ways that unscrupulous providers take advantage of the system for their personal gain. But what about those underhanded providers who not only take advantage of the system itself, with things like services not rendered, medically unnecessary services, upcoding, and the slew of vernacular, but those same…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Hidden Dangers of a 1099

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 was recently speaking to a friend, who was describing a situation he…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Telehealth & Telemedicine

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. The topic of telemedicine and telehealth has been a very hot topic in…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Unconventional Kickbacks

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. In my blog posts the past few weeks, I discussed those instances when…

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