Back to Reality: Takeaways from NAMPI 2016

Last week, Advize Health returned to Florida after fighting fraud in Baltimore during NAMPI 2016. This annual National Association for Medicaid Program Integrity took place from August 28-31st, and was held at the Baltimore Marriott Waterfront Hotel. This conference...

Does Incident-To Have You Perplexed?

Stringent billing guidelines and regulations are often instituted to limit the incidence of fraud, waste, and abuse (FWA). Specificity increases annually, providing a well-developed outline for physicians and billers. Revisions to billing procedures are designed to...

Fraud Waste and Abuse Fact – October

Whistleblower Lawsuit Leads to Record Setting Settlement for Adventist Health System Adventist Health System will pay $118.7 million to the federal government and four states to settle a whistleblower lawsuit filed in December 2012. The lawsuit alleged that Adventist...

Fraud, Waste and Abuse Fact: September

Affordable Care Act Fraud Criminals Facing Tougher Sentences Due to the Affordable Care Act, criminals convicted of fraud now face tougher sentences and more jail time. Criminals will receive 20 to 50 percent longer sentences for crimes that involve more than $1...

Fraud Waste and Abuse Fact: August

DOJ and HHS Annual Report Highlights $3.3 Billion in Settlements and Judgments in FY 2014 “On March 19, 2015, the Department of Justice (DOJ) and Department of Health and Human Services (HHS) issued their annual Health Care Fraud and Abuse Control (HCFAC) Program...

12 Healthcare Fraud, Waste, & Abuse Facts

Fraud accounts for 19% of the $600 to $800B in waste in the U.S. healthcare system annually, including everything from bogus Medicare claims to kickbacks for worthless treatments and other services. 57% of insurers expect to see an increase in fraud losses this year...