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Fraud

Do AOs police fraud?

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07/03/2019

YARMOUTH, Maine – Accreditation organizations help to prevent and eliminate fraud, waste and abuse in the Medicare program, but it’s not their main job, they say.

Industry knew feds would bust ‘obvious’ fraud

‘It’s a clear kickback, black and white’
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04/12/2019

WASHINGTON – HME industry stakeholders aren’t surprised by a $1.2 billion fraud scheme involving medically unnecessary braces and they’re glad to see “bad actors” punished.

Feds bust $1.2B brace fraud scheme

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04/10/2019

WASHINGTON – The federal government has charged 24 defendants, including executives at five telemedicine companies, the owners of dozens of DME companies and three licensed medical professionals, for their roles in a healthcare fraud scheme that resulted in $1.2 billion i

Bill tries to force CMS’s hand on O&P certification

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05/30/2017

WASHINGTON – Reps. Glenn “GT” Thompson, R-Pa., and Mike Thompson, D-Calif., have once again introduced a bill that calls on CMS to enforce a law that O&P providers be certified to receive payments under Medicare.

CareCentrix, Performant specialize fraud efforts

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05/23/2017

HARTFORD, Conn. – CareCentrix has teamed up with Performant Financial Corporation, the new national RAC for DME, home health and hospice, to deploy specialized analytics and algorithms to better identify and decrease waste and fraud, it announced May 23.

Rep. Price says audits should focus on actual fraud

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01/26/2017

WASHINGTON – Rep. Tom Price, R-Ga., nominee for secretary of Department of Health and Human Services, told members of the Senate Finance Committee that he thinks the agency should focus audits on weeding out blatant fraud instead of verifying medical necessity. The comments came in response to a question from Sen. Orrin Hatch, R-Utah, about what HHS can do to protect Medicaid from scammers, according to an article on Law360. The Senate Finance committee will vote soon on whether to accept Price’s nomination.

Whistleblower details alleged fraud at Lincare

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07/12/2016

CLEARWATER, Fla. – A former employee says Lincare has been knowingly defrauding the government of millions of dollars by allegedly billing false claims to Medicare.

Texas providers charged with healthcare fraud

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04/07/2016

MCALLEN, Texas – Federal charges have been filed against two DME owners for allegedly defrauding Texas Medicaid/Medicare through false billings, the Southern District of Texas U.S. Attorney’s Office has announced.

OIG certifies CMS’s fraud savings

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07/16/2015

WASHINGTON – The Office of Inspector General has certified $133.2 million of actual and projected savings from CMS’s Fraud Prevention System, a return of investment of $2.84 for every dollar spent on the system.

CMS uses data to thwart $820M in fraud

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07/14/2015

WASHINGTON – CMS’s Fraud Prevention System has identified and prevented $820 million in inappropriate payments in three years of use, the agency announced today.

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