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April 18, 2018 Healthcare Fraud

Anti-Kickback Medicare Part B Fraud Under the Federal False Claims Act

Waiving co-payments and deductibles required under Medicare Part B is a basis for a whistleblower to bring a claim under the federal False Claims Act. About the Medicare Part B Program Title XVIII of the Social Security Act prescribes coverage requirements under Part B of the Medicare program. Medicare Part […]
December 13, 2017 Healthcare Fraud

Whistleblowing in Nursing

Nurses have long been a crucial part of the healthcare system, and they can be just as crucial when it comes to reporting fraud within that system. As insiders and observers of many healthcare procedures and billing practices, nurses have much-needed visibility into wrongdoing being committed by hospitals, physician-practice groups, […]
October 30, 2017 Healthcare Fraud

What is Medi-Cal Fraud?

Medi-Cal is the name of the State of California’s Medicaid program, as well as certain state healthcare programs. Medi-Cal is administered by the California Department of Health Services and accounts for more than $40 billion in annual expenditures – nearly one-quarter of the state’s entire budget. Medi-Cal provides health coverage […]
October 20, 2017 Healthcare Fraud

Medicare Fraud: Billing for Services Not Rendered

Imagine the following scenario: a patient with Medicare sprains her ankle and sees a doctor for one 15 minute appointment. The doctor then bills Medicare as if he had seen the patient for five 15 minute appointments over the course of a month. The doctor figures that Medicare will never […]
October 16, 2017 Healthcare Fraud

What is the Medicare Fraud Strike Force?

Although fraud against the federal and state governments occurs in many different industries, there is always a lot of attention paid to healthcare fraud because it involves such enormous government expenditures, and it has such a huge impact on the beneficiaries of government healthcare programs. That impact can be through […]
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