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(Reuters) -Planned Parenthood must face a trial in a $1.8 billion lawsuit by Texas accusing the organization of defrauding the Republican-led state's Medicaid health insurance program, a federal ...
A Discharge Monitoring Report (DMR) is a United States regulatory term for a periodic water pollution report prepared by industries, municipalities and other facilities discharging to surface waters. [ 1 ] : 8–14 The facilities collect wastewater samples, conduct chemical and/or biological tests of the samples, and submit reports to a state ...
Bailee is one of 10,812 Texas children who lost Medicaid coverage and then were enrolled in the state's Children's Health Insurance Program, which is similar to Medicaid but with a higher ...
In the fall of 2012, as part of an investigation examining Medicaid fraud in Texas, the state Medicaid program began auditing All Smiles. [4] The Federal Government charged Malouf with fraudulent Medicaid billing for four years ending in the year 2007; the charges did not include his large Medicaid brace expenditures. [7]
A case of Medicaid fraud was carried out in 2010 by an Armenian-American organized crime group called the Mirzoyan–Terdjanian organization. [1] [2] The scam involved a crime syndicate which created 118 fake clinics in 25 states and used stolen medical license numbers of real doctors and matched them to legitimate Medicare patients whose names and billing information were also stolen.
Conflicting information, computer systems not working, denials before verification and more problems come to the surface from whistleblowers, advocacy groups.
Prosecutors accuse these companies of overbilling for care that isn’t required, refusing to discharge patients who improve and enrolling people who aren’t dying. Some people receiving the Medicare hospice benefit, which pays all hospice costs provided patients meet a set of criteria that indicate death is imminent, were healthy enough to ...
PPACA clarified the changes to the FCA made by FERA. Under PPACA, overpayments under Medicare and Medicaid must be reported and returned within 60 days of discovery, or the date a corresponding hospital report is due. Failure to timely report and return an overpayment exposes a provider to liability under the FCA. Statutory Anti-Kickback Liability.
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