Healthcare Fraud Cases Examples

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Nurse Practitioner Sentenced in Twelve Million Dollar …

(3 days ago) WebPROVIDENCE, R.I. – A registered nurse and nurse practitioner, who defrauded commercial health insurers and Medicare of nearly $12 million by devising and executing fraudulent billing schemes in

https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/press-releases/nurse-practitioner-sentenced-twelve-million-dollar-health-care-fraud-scheme

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Serial Health Care Fraudster Sentenced for $234M …

(6 days ago) WebAccording to court documents, Imran Shams, 65, of Glendale, was convicted of Medicare and Medicaid fraud in separate 1990 and 2001 cases in New York and …

https://www.justice.gov/opa/pr/serial-health-care-fraudster-sentenced-234m-medicare-fraud-scheme

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Medical Doctor Charged for $20.7M Health Care Fraud …

(5 days ago) WebA federal grand jury in New Jersey returned a superseding indictment yesterday charging a medical doctor with allegedly engaging in a health care fraud and …

https://www.justice.gov/opa/pr/medical-doctor-charged-207m-health-care-fraud-and-illegal-kickback-schemes

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Criminal Division Case Summaries - United States …

(3 days ago) WebJune 28, 2023. Summary of Criminal Charges. Central District of California. Neda Mehrabani, 47, of Tarzana, California, was charged by information with health care …

https://www.justice.gov/criminal/criminal-fraud/health-care-fraud-unit/2023-national-hcf-case-summaries

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Top Healthcare Fraud Takedowns of 2020

(6 days ago) WebFeds charge 10 individuals in $1.4B rural hospital billing scheme. One of the largest healthcare fraud takedowns in 2020 involved charges against 10 individuals, including hospital managers, laboratory …

https://revcycleintelligence.com/news/top-healthcare-fraud-takedowns-of-2020

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Health Care Fraud — FBI

(8 days ago) WebHealth care fraud is not a victimless crime. It affects everyone and causes tens of billions of dollars in losses each year. The FBI is the primary agency for investigating health care fraud, for

https://www.fbi.gov/investigate/white-collar-crime/health-care-fraud

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Justice Department charges 78 in multibillion-dollar …

(Just Now) WebA case out of the Southern District of Florida was among one of the largest health care fraud schemes ever prosecuted, agency officials said. The indictment …

https://www.npr.org/2023/06/28/1184795720/78-people-face-charges-for-2-5-billion-in-attempted-health-care-fraud-doj-says

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DOJ announces 78 people charged over $2.5 billion in false health …

(5 days ago) WebThe cases unsealed over a two-week period this month included "one of the largest health care fraud schemes ever prosecuted" by the department, in which two top …

https://abcnews.go.com/Politics/doj-announces-78-people-charged-nationwide-health-care/story?id=100447219

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8 Frightening Healthcare Fraud Examples in Real Life

(1 days ago) WebMedical Identity Theft Example 1. In September of 2021, a Las Vegas resident received 144 months in federal prison and a $4,321,590.39 fine for conspiring to defraud the North Carolina Medicaid …

https://etactics.com/blog/healthcare-fraud-examples

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The Challenge of Health Care Fraud – NHCAA

(6 days ago) WebEveryone Shares the Burden of Health Care Fraud. In 2018, $3.6 trillion was spent on health care in the United States, representing billions in health insurance claims. It is an …

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

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Four People Plead Guilty, Sentenced for Multi-Million-Dollar …

(5 days ago) WebIn February, Satine pleaded guilty to felony Medicaid fraud and theft by deception and was sentenced to 1½ to 5 years in state prison. He is required to pay $2.8 …

https://www.attorneygeneral.gov/taking-action/four-people-plead-guilty-sentenced-for-multi-million-dollar-medicaid-fraud-scheme-that-involved-inflated-transportation-costs-other-phantom-services/

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Healthcare billing fraud: 9 recent cases - Becker's Hospital Review

(6 days ago) Web6. Bon Secours Mercy Health settles false claims case for $1M. Cincinnati-based Bon Secours Mercy Health agreed to pay $1 million to settle allegations that it …

https://www.beckershospitalreview.com/legal-regulatory-issues/healthcare-billing-fraud-9-recent-cases.html

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Common Types of Health Care Fraud Fact Sheet - Centers for …

(Just Now) WebThis fact sheet provides a brief overview of some common types of Medicaid fraud, waste, and abuse involving providers. Although the examples involve violation of Federal laws, …

https://www.cms.gov/files/document/overviewfwacommonfraudtypesfactsheet072616pdf

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Justice Department Charges Dozens for $1.2 Billion in Health Care …

(3 days ago) Web“HHS-OIG is proud to work alongside our law enforcement partners to disrupt fraud schemes that use the guise of telehealth to expand the reach of kickback schemes …

https://www.justice.gov/opa/pr/justice-department-charges-dozens-12-billion-health-care-fraud

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US announces charges in $2.5 billion healthcare fraud takedown

(9 days ago) WebThe U.S. Justice Department on Wednesday announced federal and local criminal charges targeting 78 defendants across 16 states as part of a law enforcement …

https://www.reuters.com/legal/us-announces-charges-25-billion-healthcare-fraud-takedown-2023-06-28/

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Health Care Fraud - Definition, Examples, Cases, Processes

(6 days ago) WebDefinition of Health Care Fraud. Noun. The knowing and willful executing, or attempt to execute, a scheme or deceit to defraud a health care insurance or benefit …

https://legaldictionary.net/health-care-fraud/

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Combating Health Care Fraud and Abuse: Conceptualization and

(3 days ago) WebHealth care fraud and abuse involve all sectors of the health care industry, including drug and device manufacturers, hospitals, pharmacies, physicians, …

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

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Health care fraud: Ex-Bergen jail guard admits participating in …

(5 days ago) WebFormer Bergen jail guard admits to helping defraud county health care system of $3 million. A former Bergen County corrections officer admitted in federal court …

https://www.northjersey.com/story/news/bergen/2021/04/21/bergen-county-corrections-officer-admits-defrauding-county-healthcare-system/7325076002/

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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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Whistleblowers and Medical Fraud: A Book Review

(8 days ago) WebIn medicine, whistleblowers face institutional denial, stonewalling, retaliation, and other kinds of reprisal. They expose coercive recruitment practices, conflicts of …

https://www.psychologytoday.com/intl/blog/side-effects/202405/whistleblowers-and-medical-fraud-a-book-review

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Arizona's $2 billion Medicaid fraud was first announced one year ago

(8 days ago) WebArizona Republic. 0:04. 1:34. Arizona's Medicaid agency is a "completely new" organization one year after a humanitarian crisis caused by massive fraud was …

https://www.azcentral.com/story/news/local/arizona-health/2024/05/16/arizonas-2-billion-medicaid-fraud-was-first-announced-one-year-ago/73706945007/

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Private equity in health care: three takeaways going forward

(9 days ago) WebThree takeaways are: (1) Health care reimbursement is finite. The goal of short-term investments in providers that depend on third party reimbursement is a hard …

https://www.reuters.com/legal/litigation/private-equity-health-care-three-takeaways-going-forward-2024-05-09/

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The Major Supreme Court Cases of 2024 - The New York Times

(5 days ago) WebThe Major Supreme Court Cases of 2024. By Adam Liptak , Abbie VanSickle and Alicia Parlapiano. May 9, 2024. No Supreme Court term in recent memory has …

https://www.nytimes.com/interactive/2024/05/09/us/supreme-court-major-cases-2024.html

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Office of Public Affairs National Health Care Fraud Enforcement

(8 days ago) WebThe Department of Justice announced today criminal charges against 138 defendants, including 42 doctors, nurses, and other licensed medical professionals, in …

https://www.justice.gov/opa/pr/national-health-care-fraud-enforcement-action-results-charges-involving-over-14-billion

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The Benefits of AI in Healthcare IBM

(7 days ago) WebFraud prevention: Fraud in the healthcare industry is enormous, at $380 billion/year, and raises the cost of consumers’ medical premiums and out-of-pocket …

https://www.ibm.com/think/insights/ai-healthcare-benefits

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10 Best AI Use Cases in Everyday Life - dorik.com

(Just Now) WebIn this article, we will explore 10 AI use cases. We'll see how it's changing things like business, art, healthcare, and how we get around. Let's dive in and see how …

https://dorik.com/blog/best-ai-use-cases

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Bob Menendez trial: Expect some NJ flavor in indictments - Bergen …

(1 days ago) WebMenendez has said he is innocent of all the charges. The case will bring focus to the growing push by foreign countries to peddle influence in Washington by enlisting …

https://www.northjersey.com/story/opinion/columnists/charles-stile/2024/05/16/bob-menendez-trial-nj-flavor-indictments-gold-bars/73705876007/

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2020 National Health Care Fraud and Opioid Takedown

(3 days ago) WebCases Charged in Health Care Fraud and ARPO Strike Force Locations. For example, in one case, a telemedicine doctor who was the top prescriber in the …

https://www.justice.gov/criminal/criminal-fraud/hcf-2020-takedown/case-descriptions

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USDA, HHS Announce New Actions to Reduce Impact and Spread …

(2 days ago) WebOn March 25, 2024, immediately following the first detection of H5N1 in dairy cattle in the Texas panhandle region, USDA and HHS began their work to understand the origin of …

https://www.usda.gov/media/press-releases/2024/05/10/usda-hhs-announce-new-actions-reduce-impact-and-spread-h5n1

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Clarifying the Eligibility of Deferred Action for Childhood Arrivals

(Just Now) WebStart Preamble Start Printed Page 39392 AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS). ACTION: …

https://www.federalregister.gov/documents/2024/05/08/2024-09661/clarifying-the-eligibility-of-deferred-action-for-childhood-arrivals-daca-recipients-and-certain

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Doctor And Three Others In Bergen County Charged In $10 Million …

(6 days ago) WebAccording to documents filed in this case and statements made in court: The count of conspiracy to commit health care fraud is punishable by a maximum of 10 …

https://www.justice.gov/usao-nj/pr/doctor-and-three-others-bergen-county-charged-10-million-health-care-fraud-scheme

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Federal Register :: Control of Communicable Diseases; Foreign

(4 days ago) WebIt is difficult to age dogs under six months, and CDC has documented cases of fraud involving the movement of dogs under six months of age from DMRVV high-risk …

https://www.federalregister.gov/documents/2024/05/13/2024-09676/control-of-communicable-diseases-foreign-quarantine-importation-of-dogs-and-cats

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District of New Jersey Announces Charges in Health Care Fraud …

(4 days ago) WebAndrew McCubbins, 39, of Draper, Utah, the owner of a telemedicine company, pleaded guilty by videoconference on Sept. 24, 2020, before U.S. District …

https://www.justice.gov/usao-nj/pr/district-new-jersey-announces-charges-health-care-fraud-cases-part-nationwide-federal-law

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