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Jimmy Carter signs Medicare-Medicaid Anti-Fraud and Abuse Amendments into law. The Office of Inspector General for the U.S. Department of Health and Human Services, as mandated by Public Law 95-452 (as amended), is established to protect the integrity of Department of Health and Human Services (HHS) programs, to include Medicare and Medicaid programs, as well as the health and welfare of the ...
The Zone Program Integrity Contractor (ZPIC) is an entity established in the United States by the Centers for Medicare & Medicaid Services (CMS) to combat fraud, waste and abuse in the Medicare program.
Health care fraud includes "snake oil" marketing, health insurance fraud, drug fraud, and medical fraud. Health insurance fraud occurs when a company or an individual defrauds an insurer or government health care program, such as Medicare (United States) or equivalent State programs. The manner in which this is done varies, and persons engaging ...
By Brendan Pierson (Reuters) -The U.S. Department of Justice announced a lawsuit on Wednesday accusing pharmacy chain CVS of filling illegal opioid prescriptions and billing federal health ...
John Gorman, a former Medicare official and founder of two companies that review records and conduct home visits on behalf of Medicare insurers, doesn’t think the changes will actually fix the ...
Attorney General Loretta Lynch described the arrests as the largest criminal health care fraud takedown in the history of the Justice Department. Authorities arrest 243 people in $712 million ...
Insurance fraud can be classified as either hard fraud or soft fraud. [14] Hard fraud occurs when someone deliberately plans or invents a loss, such as a collision, auto theft, or fire that is covered by their insurance policy [15] in order to claim payment for damages. Criminal rings are sometimes involved in hard fraud schemes that can steal ...
The investigation, led by the Attorney General's Office's Medicaid Fraud Division, also concluded that Evolve "upcoded" office visits, billing Mass Health for longer and more complex services than ...
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