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August 12, 2015 Healthcare Fraud

Improper ‘Balance Billing’: Examples of a Rising Trend

In yesterday’s post, we introduced an emerging concept known as “balance billing,” which results in skyrocketing medical expenses and increased medical debt for unsuspecting patients. As a brief review, balance billing occurs when a patient seeks treatment from an out-of-network doctor, who then bills the patient for the maximum allowable […]
August 11, 2015 Healthcare Fraud

Emerging Fraud Trends: The Rise of Balance Billing

At Berger Montague, we strive to keep on top of the latest emerging trends in the fraud landscape, particularly when the misconduct drives up the costs of healthcare for policyholders and taxpayers alike. Over the next two posts, we will examine an emerging fraud trend known as “balance billing,” which […]
August 10, 2015 Healthcare Fraud

Judge Orders Near-Maximum Whistleblower Reward; Cites ‘Indispensable Contribution’

One of the key components of the success of the False Claims Act is its ability to incentivize whistleblowers to come forward by offering up to 30 percent of the total settlement in some cases. In today’s post, we examine an interesting holding by the U.S. District Court for the […]
August 6, 2015 Healthcare Fraud

OIG Raises Concerns Over Possible Abuse of Controlled Substances Within Medicare Part D

In yesterday’s post, we introduced a possible correlation between the growth of Medicare spending on highly-addictive prescription drugs and potential Medicare fraud by wayward retail pharmacies. As a bit of review, spending for Medicare Part D administration has increased 136 percent overall since 2006. However, spending for opioids – including […]
August 5, 2015 Healthcare Fraud

New Report Highlights Growing Trend of Medicare Part D Fraud & Opioid Abuse

Over the next two posts, we will examine a recent report published by the Office of Inspector General, along with the U.S. Department of Health and Human Services. In the report, which is entitled “Questionable Billing and Geographic Hotspots Point to Potential Fraud and Abuse in Medicare Part D,” authorities […]
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