Showing posts with label fraud. Show all posts
Showing posts with label fraud. Show all posts

Monday, February 10, 2014

The Rise Of Medical Identity Theft In Healthcare

The Rise Of Medical Identity Theft In Healthcare by Michael Ollove.  Stateline.  February 7, 2014.

(1)  Medical-relate identity theft accounted for __________ percent of all identity thefts reported in the United States in 2013.

(2)  True or False:  Banking and finance-related identity thefts accounts for more identity thefts than medical ones,

(3)  Medical identity theft is done in order to illegally obtain _________________________________.
(4)  True or False:  A victim of medical identity theft has several means of recourse for recovery.

(5)  The theft of a computer or other electronic device is involved in ________________ of medical-related security breaches.

(6)  Two federal laws governing the confidentiality of medical records are ______________________________________________________.



Monday, January 27, 2014

In Medicare Overcharging Crackdown, Government May, For The First Time Disclose How Much Individual Doctors Receive In Payments

Doctors Abusing Medicare Face Fines And Expulsion by Robert Pear.  Thge New York Times.  January 25, 2014.

(1)  Federal officials estimate that __________ of payments in the traditional fee-for-service Medicare program are improper.

(2)  Based upon this estimate it is suggested that there is at least _____________ a year in improper payments under Medicare's physician fee schedule.

(3)  About _______ doctors receive payments of more thant $3 million each in yearly Medicare payments.

(4)  Most of the high-billing doctors specialize in ____________________.

(5)  What concerns do physicians have about releasing payment data?

Sunday, April 14, 2013

Overview of Waste In Health Care

Reducing Waste In Health Care.  Health Affairs--Health Policy Briefs.  December 13, 2012.

Eliminating Fraud And Abuse.  Health Affairs--Health Policy Briefs.  July 31. 2012.

These two briefs together provide a comprehensive basic overview of the waste problem in health care. A couple of randomly selected highlights:

*Every line of each  of Medicare's daily 4.5 million fee-for-services claims is examined by advanced analytic models to spot fraud.

*Eastern European crime organizations have been traced to some cases of Medicare fraud.

*"Adverse events" occur in one-third of hospital admissions according to a 2011 study.

*Small physician practices incur four times the administrative costs of small physician practices in Canada, where physicians have to interact with a single payer agency.

Wednesday, April 10, 2013

Cardiologist Admits Fraudulent Billings Totaling $19 Million

Prominent Tri-State Cardiologist Admits Record $19 Million Billing Fraud Scheme That Exposed Patients To Unskilled And Unnecessary Treatments.  7th Space Interactive.

The fraud is apparently a record for New York, New Jersey, and Connecticut.   The FBI and the Inspector General of the United States Department of Health and Human Services and many other investigative agencies were involved in the investigation.  He ordered the same tests for all patients and falsified patient charts among other misdeeds.  Read this account.  It truly is mind-boggling.

Sunday, October 7, 2012

Medicare Fraud Crackdown

Authorities Charge 91 in 430 million Medicare Fraud by David Ingram and David Morgan.  Reuters.  October 4, 2012.

Unnecessary ambulance rides, prescriptions for unqualified patients, unnecessary ambulance rides, kickbacks, identity theft, and money laundering were some of the fraudulent practices charged.  Doctors, nurses, and other medical professionals were among the 91 charged.