Health Care Fraud Scholarly Articles

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Combating Health Care Fraud and Abuse: …

(3 days ago) WEBConclusions. The proposed framework and the initial prototype have the potential to improve the health care claims process by using blockchain technology for …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516680/

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UPCODING MEDICARE: IS HEALTHCARE FRAUD AND …

(3 days ago) WEBIntroduction. Medicare fraud has been defined by the Centers for Medicare and Medicaid Services (CMS) as submitted or caused to have been submitted, false …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649706/

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Health Care Fraud: The Leading Violation of the False …

(1 days ago) WEBIt is a sign of the times when the lion's share of the schemes intent on defrauding the federal government are in the health care arena.1 Data reported by the …

https://www.amjmed.com/article/S0002-9343(22)00046-8/fulltext

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Categorizing and Describing the Types of Fraud in …

(7 days ago) WEBAbstract. Today, the over $2 trillion US healthcare system is ravaged by fraud, waste, and abuse, with an estimated one-third of all these costs frivolously spent …

https://www.sciencedirect.com/science/article/pii/S1877050915027295

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Fraud, Abuse, and Financial Conflicts of Interest NEJM

(Just Now) WEBDisclosure Forms (nejmp2201628_disclosures.pdf) Download. 78.18 KB. Increased attention and ever-growing complexity in the area of health care fraud-and-abuse regulation require the …

https://www.nejm.org/doi/full/10.1056/NEJMp2201628

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How to detect healthcare fraud? “A systematic review”

(7 days ago) WEBFraud is increasingly rampant in the care and health services industry. 22 In connection with the findings on one of the reviewed articles, the privacy laws can be a …

https://www.sciencedirect.com/science/article/pii/S0213911121002661

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Medical professionals and health care fraud: Do they aid …

(7 days ago) WEBIdentity thefts facilitated health care fraud, whereas different dimensions of health insurance (including the share of the population with Medicare, managed care, …

https://onlinelibrary.wiley.com/doi/full/10.1002/mde.3117

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Recommendations to protect patients and health care …

(Just Now) WEBFraud is defined as knowingly submitting, or causing to be submitted, false claims or making misrepresentations of a fact to obtain a federal health care payment …

https://www.japha.org/article/S1544-3191(20)30247-8/fulltext

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What Should Health Care Organizations Do to Reduce …

(4 days ago) WEBIn the 2018 fiscal year, the Department of Justice won or negotiated $2.3 billion in judgments or settlements relating to health care fraud and abuse, including 1139 criminal fraud investigations. 3 Modifications to the …

https://journalofethics.ama-assn.org/article/what-should-health-care-organizations-do-reduce-billing-fraud-and-abuse/2020-03

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Fourteen years of manifestations and factors of health insurance …

(5 days ago) WEBHealthcare fraud entails great financial and human losses; however, there is no consensus regarding its definition, nor is there an inventory of its manifestations …

https://healthandjusticejournal.biomedcentral.com/articles/10.1186/s40352-021-00149-3

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Combating Health Care Fraud and Abuse: Conceptualization and

(5 days ago) WEBBackground: An estimated US $2.6 billion loss is attributed to health care fraud and abuse. With traditional health care claims verification and reimbursement, the …

https://www.jmir.org/2020/9/e18623/

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Health Care Fraud: The Leading Violation of the False Claims Act

(1 days ago) WEBHealth Care Fraud: The Leading Violation of the False Claims Act. Health Care Fraud: The Leading Violation of the False Claims Act Am J Med. 2022 May;135(5):558-559. …

https://pubmed.ncbi.nlm.nih.gov/35114174/

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Health Care Fraud: Physicians as White Collar Criminals?

(4 days ago) WEBThe National Health Care Anti-Fraud Association estimated that health care fraud accounted for 3 percent of the health care expenditures, or $68 billion, in 2007, while …

https://jaapl.org/content/37/3/286

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Association Between Fraud and Abuse Perpetrators and Medicare

(3 days ago) WEBKey Points. Question Is receiving treatment from fraud and abuse perpetrators (FAPs) associated with adverse health events among Medicare …

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2753426

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Kickbacks, Self-Referrals, and False Claims - CHEST

(7 days ago) WEBThe fraud and abuse laws that govern conduct related to the federal health-care programs, such as Medicare and Medicaid, impose broad and complex limitations on billing …

https://journal.chestnet.org/article/S0012-3692(13)60623-6/fulltext

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Combating Fraud In Health Care: An Essential Component Of Any …

(9 days ago) WEBThe full extent of health care fraud cannot be measured precisely. However, the Federal Bureau of Investigation (FBI) estimates that fraudulent billings to public and …

https://www.healthaffairs.org/doi/10.1377/hlthaff.28.5.1351

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Fourteen years of manifestations and factors of health insurance …

(3 days ago) WEB‘The Problem of Health Care Fraud: A serious and costly reality for all Americans’, National Health Care Anti-Fraud Association (NHCAA) 2018. [Google …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8482647/

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Federal and State Agencies Crack Down on Health Care Fraud

(7 days ago) WEBThe enforcement action, which involved agencies including the Federal Bureau of Investigation and the Department of Health and Human Services’ Office of Inspector …

https://jamanetwork.com/journals/jama/fullarticle/2807424

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Big Data fraud detection using multiple medicare data sources

(6 days ago) WEBA survey on the state of healthcare upcoding fraud analysis and detection. Health Serv Outcomes Res Methodol. 2017;17(1):31–55. Article Google Scholar …

https://journalofbigdata.springeropen.com/articles/10.1186/s40537-018-0138-3

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The Challenge of Health Care Fraud – NHCAA

(6 days ago) WEBThe National Health Care Anti-Fraud Association (NHCAA) estimates that the financial losses due to health care fraud are in the tens of billions of dollars each year. A …

https://www.nhcaa.org/tools-insights/about-health-care-fraud/the-challenge-of-health-care-fraud/

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Federal Fraud Cases Unfold in Healthcare and Cybersecurity

(Just Now) WEBIf the two individuals are convicted, they face a penalty of up to 20 years in prison for each count. The DOJ press release can be found here. Recent cases include …

https://natlawreview.com/article/testing-facility-settles-25-million-anti-kickback-lawsuit

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Cyberattack disrupts operations at major US health care network

(6 days ago) WEBCNN —. A cyberattack has disrupted “clinical operations” at major health care nonprofit Ascension, forcing it to take steps to minimize any impact to patient care, …

https://www.cnn.com/2024/05/08/tech/cyberattack-disrupts-healthcare-network/index.html

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Exploring the Relationship Between Early Life Exposures and the

(1 days ago) WEBAbstract Background: Epidemiological research commonly investigates single exposure-outcome relationships, while childrens experiences across a variety of early …

https://www.medrxiv.org/content/10.1101/2024.05.13.24307277v1

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Medicare and Medicaid fraudsters continue to steal taxpayer money

(1 days ago) WEBFiscal year 2023 proved to be a high value one for healthcare frauds and settlements, with the DOJ totaling $2 billion dollars in illicit activity. The U.S. Department …

https://www.thomsonreuters.com/en-us/posts/investigation-fraud-and-risk/medicare-medicaid-fraud-2024/

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Update on Department of Justice Healthcare Fraud Investigations

(9 days ago) WEBOn April 26, the US Department of Justice (DOJ) announced that Manishkumar Patel pleaded guilty to charges related to a $50 million health care fraud …

https://www.natlawreview.com/article/doj-secures-plea-50-million-medicare-fraud-and-kickback-scheme

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Lesional liver biopsies: better treatments, better - Oxford Academic

(7 days ago) WEBBy contrast, liver lesions are not biopsied as routine standard of care because tissue confirmation usually offers little diagnostic advantage over non-invasive imaging …

https://academic.oup.com/bjs/article-abstract/111/5/znae063/7674990

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Medical Students Develop Course to Train Their Peers in Trauma …

(9 days ago) WEBFrom left, Michael Lamb, PhD, director of surgical education and course instructor, Gaby Cordero, MD, who took the course in her fourth year of medical school, …

https://medicine.buffalo.edu/news_and_events/news/2024/05/lamb-trauma-elective-19436.html

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Glen 'Big Baby' Davis sentenced to 40 months in prison over fraud

(4 days ago) WEBESPN. Glen "Big Baby" Davis was sentenced by a federal judge to 40 months in prison for his conviction in an alleged scheme to defraud the NBA's health …

https://www.espn.com/nba/story/_/id/40113791/glen-big-baby-davis-sentenced-40-months-prison-fraud-scheme

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Steward Health Files Chapter 11 After Medical Properties Deal

(2 days ago) WEBIn January, Medical Properties provided Steward Health with a $60 million bridge loan and deferred some of its rent arrears. Medical Properties fell as much as …

https://www.bloomberg.com/news/articles/2024-05-06/steward-health-files-chapter-11-after-medical-properties-deal

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Medical Students Develop Course to Train Their Peers in Trauma …

(2 days ago) WEBThe purpose is to train medical students, particularly those interested in surgery, in trauma-informed care in Buffalo’s Level 1 Adult Trauma Center at the Erie …

https://www.buffalo.edu/provost/messages.host.html/content/shared/smbs/news/2024/05/lamb-trauma-elective-19436.detail.html

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Editorial: Fraud and Corruption in Healthcare - PMC

(3 days ago) WEBThe scale of losses due to fraud and corruption in healthcare is impressive as it accounts for approximately $455 billion of the $7.35 trillion spent on healthcare …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204141/

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Glen 'Big Baby' Davis sentenced to prison time for NBA healthcare …

(4 days ago) WEBDavis was convicted by a jury in New York in November on charges of health care fraud, wire fraud, conspiracy to make false statements and conspiracy to commit …

https://www.si.com/nba/former-nba-player-glen-davis-sentenced-to-prison-01hxf82j40ss

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