fraud
publication date
Charges Brought Against 34 Suspects in $258M Multistate Fraud Schemes
Federal prosecutors arrest suspects in three states in various alleged schemes to defraud Medicare, Medicaid, employee health plans, and private...
Convicted Florida Health Care Exec Gets 20 Year Prison Term for $1.3B Fraud Scheme
Philip Esformes of Miami Beach ran the largest healthcare fraud scheme ever charged by DOJ.
Strategy
We Asked Prosecutors if Health Insurance Companies Care About Fraud. They Laughed at Us.
To protect their networks and bottom lines, health insurers don't aggressively pursue widespread fraud, making it easy for scammers. Then...
Telemedicine Company Owner Pleads Guilty to $424M Medicare Fraud Scheme
The owner of Video Doctor USA admitted that he took kickbacks and paid bribes for inducing healthcare providers to bill...
Mallinckrodt to Pay $15M to Settle False Claims Liability
The United Kingdom-based drug maker wooed doctors with lavish dinners and entertainment.
The Collapse Of A Hospital Empire — And Towns Left In The Wreckage
How companies like EmpowerHMS were able to drive so many hospitals into the ground so quickly is a story about...
Clinical Care
NJ Doc Pleads Guilty to Manslaughter for Patient's Fentanyl Death
Barry S. Sloan, MD, admitted that he gave medically unnecessary prescriptions for 'Subsys' to a 36-year-old Manhattan man who died...
Finance
Missouri Firm With Silicon Valley Ties Faces Medicare Billing Scrutiny
A recent HHS audit and a whistleblower lawsuit, have put Essence scrutiny. Medicare is conducting a separate audit.
Health Insurers Make It Easy for Scammers to Steal Millions. Who Pays? You.
Health insurers are regarded as fierce defenders of healthcare dollars. But the case of David Williams shows one reason America's...
Hospital Pass-through Billing Scheme Detailed in Florida Plea Agreement
Kyle Marcotte of Jacksonville Beach admitted to using rural hospitals in a scheme that kicked back more than $50 million...
Encompass Health to Pay $48M to Settle False Claims Allegations
Federal prosecutors said the company allegedly submitted false diagnoses to maintain its status as a Medicare IRF and get a...
Pain Management Doc Allegedly Took Bribes, Kickbacks to Prescribe Fentanyl
Sun allegedly received $140,000 in bribes and kickbacks from Insys Therapeutics in exchange for prescribing more than 28 million micrograms...