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  2. False Claims Act of 1863 - Wikipedia

    en.wikipedia.org/wiki/False_Claims_Act_of_1863

    [25] The False Claims Act requires a separate penalty for each violation of the statute. [26] Under the Civil Penalties Inflation Adjustment Act, [24] False Claims Act penalties are periodically adjusted for inflation. [26] In 2020, the penalties range from $11,665 to $23,331 per violation. [27] Certain claims are not actionable, including:

  3. Health care fraud - Wikipedia

    en.wikipedia.org/wiki/Health_care_fraud

    Billing Medicare programs for services that are more costly than the actual procedure that was done. [5] It is a form of billing fraud where healthcare service providers submit false billing codes to obtain higher reimbursement at the expense of programs like Medicare, Medicaid, and TRICARE. [7]

  4. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    Achieving a high clean claims rate is a key metric for measuring the efficiency of the billing cycle. Creation of the claim is where medical billing most directly overlaps with medical coding because billers take the ICD/CPT codes used by the medical coders and creates the claim. Step 6: Monitoring payor Adjudication [4]

  5. Walgreens must face US, Virginia Medicaid fraud lawsuit over ...

    www.aol.com/news/walgreen-must-face-us-lawsuit...

    In a 3-0 decision, the 4th U.S. Circuit Court of Appeals in Richmond, Virginia, cleared the way for the nation's largest pharmacy chain to face claims it violated the federal False Claims Act and ...

  6. Medicare fraud - Wikipedia

    en.wikipedia.org/wiki/Medicare_fraud

    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 ...

  7. Judge orders Montana health clinic to pay nearly $6 million ...

    www.aol.com/news/judge-orders-montana-health...

    A health clinic in a Montana town plagued by deadly asbestos contamination must pay the government almost $6 million in penalties and damages after it submitted hundreds of false asbestos claims ...

  8. Jury says health clinic in Montana Superfund town submitted ...

    www.aol.com/news/superfund-towns-health-clinic...

    A federal jury ruled Wednesday that a health clinic in a Montana town where hundreds of people have died from asbestos exposure submitted 337 false asbestos claims that made patients eligible for ...

  9. Office of Inspector General, U.S. Department of Health and ...

    en.wikipedia.org/wiki/Office_of_Inspector...

    OCIG is an in-house, full-service law office, providing legal advice to OIG and compliance guidance to the healthcare industry. OCIG also provides enforcement and compliance measures, working with DOJ on False Claims Act cases and independently on OIG administrative civil monetary penalty and exclusion actions.

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