SACRAMENTO, Calif. — Getting clean drinking water cost Ignacio Padilla his health insurance. The World War II veteran needed to repay the loan for the water pump installed on his 1-acre property in rural Tulare County, the only source of water to his mobile home. He carefully socked away a few thousand dollars so he…
The budget package Democrats are assembling in Congress would likely provide the biggest jolt to the American health care system since the passage of the Affordable Care Act in 2010, according to sources familiar with work on the plan. Democrats in the Senate announced Tuesday night that they had reached a framework for a $3.5 trillion…
A federal price transparency rule that took effect this year was supposed to give patients, employers and insurers a clearer picture of the true cost of hospital care. When the Trump administration unveiled the rule in 2019, Seema Verma, then chief of the Centers for Medicare & Medicaid Services, promised it would “upend the status quo to empower patients…
The new head of the federal agency that oversees health benefits for nearly 150 million Americans and $1 trillion in federal spending said in one of her first interviews that her top priorities will be broadening insurance coverage and ensuring health equity. “We’ve seen through the pandemic what happens when people don’t have health insurance…
Patricia Denny and her husband, Jeff, had hoped to one day get an RV and travel the country. Instead, Jeff has been forced into retirement at age 54 by a lung disease caused by the asbestos that’s polluted the small town of Libby, Montana, for decades. Jeff Denny’s lungs are damaged from the asbestos he…
Our Founder and Managing Director Jeanmarie Loria sat down with retired OIG Special Agent Eric Rubenstein to discuss dental fraud, unscrupulous dentists, and the claims-related intricacies of the dental industry. Here’s how it went… JL: My aunt in California paid an additional $10 for personal protective equipment (PPE) on top of her dental visit. Other members…
Friend of Advize and healthcare payer expert Dino Kasdagly put together a helpful resource for healthcare professionals looking to quickly refresh their knowledge on Medicare as a Secondary Payer practices. Below you will find several popular instances in which Medicare benefits are secondary to Group Health Plan (GHP) benefits. If the documented employer has more…
The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. Recently, we discussed a situation where Medicare may still pay for a service, item or procedure…
Healthcare fraud is a pervasive issue, we all know this. We write about its effects every week here at Advize Health, and thousands of our compatriots have dedicated their professional lives to put a stop to the issue – much to no avail. Sadly, it seems that healthcare fraud is here to stay. This is…
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 we have progressed over the past several months for billing, coding, and…