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Huff Post Business: Health Care Fraud Investigations Pulling In $8 for Every Dollar Spent

  Earlier this month, the departments of Justice and Health and Human services announced they recovered nearly $8 for every dollar invested in anti-fraud efforts in 2012. FROM HUFFINGTONPOST.COM: In particular, the hospital disclosed that it admitted patients for short stays – typically one or two days – that were not warranted by the patient’s medical condition, and thereby generated a larger reimbursement than was proper for each patient.   Of the $4.9 million to be paid by St. Joseph’s, $4.6 […]

U.S. Department of Justice: Maryland Hospital Agrees to Pay $4.9M for Medically Unnecessary Hospital Admissions

  The Justice Department reports that a Towson, MD, hospital will pay $4.9M for false claims to Medicare, Medicaid and other federal healthcare programs. FROM THE U.S. DEPARTMENT OF JUSTICE: In particular, the hospital disclosed that it admitted patients for short stays – typically one or two days – that were not warranted by the patient’s medical condition, and thereby generated a larger reimbursement than was proper for each patient.   Of the $4.9 million to be paid by St. Joseph’s, […]

Fox Business News: How big is Medicare fraud?

  In this story, Fox News discusses the rate of healthcare fraud and the impact on government retirement programs. FROM FOX BUSINESS NEWS: How big a retirement planning problem is Medicare fraud? In a May 2012 report, FBI Special Agent David Welker said, “The United States spends more than $2.5 trillion on health care annually, and rough estimates indicate that anywhere from 3% to 10% of all health care expenditures are attributed to fraud.” If you do Welker’s math, the […]

CBS News: The SCOOTER store power wheelchair company raided in federal probe

  As part of ongoing coverage of healthcare fraud, CBS News delves into the case of The SCOOTER Store, a power wheelchair company that overbilled Medicare by $108 million. FROM CBS NEWS: The issue is that once a doctor has written a prescription, Medicare rarely verifies whether the chairs are actually necessary. The problem was crystallized when the Inspector General of the Department of Health and Human Services released this report, finding that industry-wide, 80 percent of Medicare payments for power […]

Coalition Launches New Website

  The American Coalition for Healthcare Claims Integrity (ACHCI) today announced the launch of a new website, ProperPayments.org, that highlights the ongoing work of government accountability programs and private sector partners in the fight against waste, fraud and abuse in the nation’s healthcare system. Founded in 2009, the American Coalition for Healthcare Claims Integrity (ACHCI) is a non-profit organization committed to achieving 100% accuracy in payment claims submitted to public and private sector healthcare payors. The coalition’s mission is to educate […]

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FBI Uncovers $8.5M Medicare Fraud Scheme in Manhattan

  From the FBI website: Manhattan Doctor Pleads Guilty to $8.5 Million Medicare Fraud Scheme  Preet Bharara, the United States Attorney for the Southern District of New York, announced that Dr. Roberto Aymat, a medical doctor, pled guilty today in Manhattan federal court to participating in a scheme to defraud Medicare out of approximately $8.5 million through the use of fraudulent HIV/AIDS clinics in New York. As part of the scheme, Aymat and others billed Medicare for medications that were […]

’60 Minutes’ Tackles Hospital Fraud

Recently, 60 Minutes investigated Health Management Associates, the fourth largest for-profit hospital chain in the country. An estimated $210 billion a year goes toward unnecessary tests and treatments, with a large chunk of those tests being billed to Medicare and Medicaid programs. Watch the story to learn more about widespread fraud in the system.