Two weeks ago, we featured a personal story of mine and related it to Elizabeth Holmes and a Mount Carmel doctor who was found to deliver inappropriate medications in a deadly way. Thank you for those of you who responded. Interestingly enough, one person sent an email about a healthcare provider who is thought to…
….and all the sinners saints. Yup, I love that Stones song too. Arguably one of the best rock bands ever, The Rolling Stones came from London which is where the doctor on my mind practiced his career in oncology at The Royal Marsden and then St Bartholomew’s Hospitals. Read more about the impressive resume here,…
More than a dozen former NBA players have been charged in New York federal court in an alleged multi-million-dollar health insurance fraud scheme to rip off the league’s benefit plan
Close to 500,000 people are dead because of opioid overdoses in the USA from 1999 to 2019, according to the U.S. Centers for Disease Control and Prevention. Last week, we likened an overprescribing doctor to Elizabeth Holmes. This week, we are excited to see a groundbreaking settlement: The first settlement with a tribal government in the…
When I was first hired as an OIG Agent, I was told by numerous people that fraud in the Medicare Advantage (MA) world was difficult to commit, and ever more difficult to prove. To put it into context, it was the mid-1990s, and MA plans were not where they are today. That being said, I always…
“Justice delayed is justice denied” by William Gladstone is a quote that comes to mind when I think about fraudulent providers and Elizabeth Holmes. I am obsessed with the podcast The Drop Out, featuring the trial of Elizabeth Holmes, and this week’s episode was released within days of the 600 pages of personal text messages…
The Justice Department has accused an upstate New York health insurance plan for seniors and its medical analytics company of cheating the government out of tens of millions of dollars. The civil complaint of fraud, filed late Monday, is the first by the federal government to target a data mining company for allegedly helping a…
The tagline from the CMS Website is “When Medicare Claims are submitted accurately, everyone benefits.” First – TPE why do we even care? Well, simple answer, it is a lovely little gift from CMS designed to help reduce claim denials and appeals through one-on-one help. As we can attest thorough masses of audits of provider…
We talk to you every week about trials and cases that are in our rearview mirror. Often what we worked on directly. Sometimes we talk about areas of interest like healthcare cost and changing policy. Sometimes we bring you best practices based on our clients. Well, step aside normal headlines. This week the Berny Madoff…
In this episode of Retro Fraud, Eric spends some time with former Deputy Chief of the Health Care and Government Fraud Unit and long-time Assistant United States Attorney Joe Mack (Joseph G. Mack).
Joe is now in the private sector, working in regulatory and compliance for healthcare, but spent a number of years as a criminal prosecutor in the US Attorney’s Office in New Jersey, on healthcare fraud matters.
Eric and Joe worked together for many years, punctuated by the Orange Community MRI case. That case resulted in about 20 prosecutions, including 17 criminal prosecutions, and three trials in 14 months. Eric and Joe discuss this overall case, the facts and prosecutorial decisions that are made and how kickbacks continue to be a problem in the healthcare world.
In this episode of Retro Fraud, Eric spends some time with former Deputy Chief of the Health Care and Government Fraud Unit and long-time Assistant United States Attorney Joe Mack (Joseph G. Mack). Joe is now in the private sector, working in regulatory and compliance for healthcare, but spent a number of years as a criminal prosecutor in…
