Department of Justice Charges 94 With Medicare Fraud Billing

Anonymous — Wed, 21 Jul 2010 01:13:00 GMT

First of all finding fake store fronts is a good idea and something has never been researched to any large degree. Florida is a huge area for fraud. Crooks are better billers so you can’t rely on electronic monitoring only as all their data looks perfect as they have one focus of fraud and do not see patients. One other big area was “dead doctors” who were rolling in their graves submitting claims. This was a disconnect of data systems to where authenticity was not being conducted by Medicare.

Medicare Fraud – Criminals Do a Better Job With Filing Claims And Coding Than Providers

There’s a video at the link below talking to one who was caught and he tells how easy it was, until he was caught.

The Creation of a “Do Not Pay List” Announced by Government – Will Help Keep those MDs in the Grave from Cashing In

The Department of Justice (DoJ) has reported that 94 people, including some doctors and healthcare company owners, have been charged for their alleged participation in schemes to collectively submit more than $251 million in false claims to the Medicare program in the continuing operation of the Medicare Fraud Strike Force across the U.S.

The joint DoJ-Department of Health and Human Services (HHS) Medicare Fraud Strike Force is a team of federal, state and local investigators charged with combating Medicare fraud through the use of Medicare data analysis techniques and an increased focus on community policing.

Charges were brought against 94 individuals who are accused of various Medicare fraud-related offenses, including conspiracy to defraud the Medicare program, criminal false claims, violations of the anti-kickback statutes and money laundering, according to DoJ. The charges are based on a variety of fraud schemes, including physical therapy and occupational therapy schemes, home healthcare schemes, HIV infusion fraud schemes and durable medical equipment (DME) schemes.

DoJ charges 94 with alleged Medicare fraud, equaling $251M

Technorati Tags: Medicare fraud, healthcare, healthcare reform, seniors, coding, billing, Nightline, Do Not Pay, Social Security, Identity theft, DOJ

The Creation of a “Do Not Pay List” Announced by Government – Will Help Keep those MDs in the Grave from Cashing In

Anonymous — Fri, 18 Jun 2010 20:34:00 GMT

The Do Not Pay list will include more than just healthcare, but the huge area here is Social Security. Fraud is a big case on everyone’s list and needs both technical and non technical support to enforce. A while back I wrote about the crooks being better billers, why, they don’t see patients and have one focus only – fraud. The link below has a couple of videos and additional information that support this and how some of these folks get by with this stuff.

Medicare Fraud – Criminals Do a Better Job With Filing Claims And Coding Than Providers

One area that hit the government in the face too was not connecting NPI numbers of deceased doctors, and there’s also billing done for dead patients too, but the NPI number should have been cross referenced a long time ago but now with infrastructure updates that is going to happen. There were multitudes of claims paid with NPI numbers from deceased doctors.

Probe finds dead doctors used in Medicare Scam

This video is from a short while back from 60 Minutes and he talks about he went about his acts of fraud and how easy it was for him, well until he was caught.

In the world of data and otherwise we almost have to anticipate and try out best to stay one step ahead of the deviate minds on the criminal side and if we don’t, well this post pretty much says all. BD

Before agencies issue payments, they must cross-check federal databases of people who have died, and of individuals and companies that have been suspended from doing business with the federal government or are otherwise ineligible to receive federal funds, President Obama ordered Friday.

Over the past three years, agencies have paid out $180 million in benefits to 20,000 Americans who are dead and more than $230 million to about 14,000 fugitives or incarcerated felons who are ineligible for payments, Vice President Biden said at a news briefing.

Obama's memorandum orders agencies to cross-check the Social Security Administration's master file of deceased individuals, the General Services Administration's list of suspended or debarred contractors, the Treasury Department's list of people who owe the government money, the Health and Human Services Department's list of individuals and businesses excluded from participating in federal health care programs, and the Housing and Urban Development Department's credit alert systems for flagging people ineligible for federal loans.

The administration plans to consolidate all of those databases into a single "Do Not Pay" list to make it easier for agencies to check the status of individuals and businesses before issuing federal payments. Officials did not say when the Do Not Pay list will be established.

Administration announces 'Do Not Pay' list - FederalTimes.com

Technorati Tags: Medicare fraud, healthcare, healthcare reform, seniors, coding, billing, Nightline, Do Not Pay, Social Security, Identity theft

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Department of Justice Charges 94 With Medicare Fraud Billing

Medicare Fraud – Criminals Do a Better Job With Filing Claims And Coding Than Providers

The Creation of a “Do Not Pay List” Announced by Government – Will Help Keep those MDs in the Grave from Cashing In

The Creation of a “Do Not Pay List” Announced by Government – Will Help Keep those MDs in the Grave from Cashing In

Medicare Fraud – Criminals Do a Better Job With Filing Claims And Coding Than Providers