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141. HHS warns of remote patient monitoring scam
HHS is warning Americans to be on the lookout for a remote patient monitoring scam. Fraudsters have been targeting Medicare enrollees, signing them up for monthly billing for remote monitoring services ...28 November 2023 -
142. Nurse practitioner pleads guilty in $7.8M fraud scheme
A Virginia-based nurse practitioner pleaded guilty for her role in a $7.8 million telemedicine fraud scheme involving medically unnecessary durable medical equipment. Between December 2018 and April ...28 November 2023 -
143. Nebraska pharmacist to pay $573K in healthcare fraud case
A Nebraska pharmacist pleaded guilty to healthcare fraud, and a federal court ordered her to pay more than $573,000 in restitution. Danelle Charf owned and operated two pharmacies in the state, and ...27 November 2023 -
144. New York physician convicted in Medicaid fraud scheme
... Nov. 22 news release from New York Attorney General Letitia James office. Dr. Toobian defrauded Medicaid and subjected patients to medically unnecessary and often invasive radiological tests "without ...27 November 2023 -
145. Drive Transformation with Oracle Cloud Infrastructure
In this episode we are joined by Amy Andersen, Vice President, Market Development Enterprise & Cloud Venture at Oracle to discuss Oracle recent acquisition of Cerner, their Modern Data Platform, fraud ...27 November 2023 -
146. Drive Transformation with Oracle Cloud Infrastructure
In this episode we are joined by Amy Andersen, Vice President, Market Development Enterprise & Cloud Venture at Oracle to discuss Oracle recent acquisition of Cerner, their Modern Data Platform, fraud ...27 November 2023 -
147. Healthcare billing fraud: 10 recent cases
From two pharmacy owners and a physician convicted in a $145 million scheme to two NBA convicted for their roles in a scheme to defraud the league's healthcare plan, here are 10 healthcare billing fraud ...22 November 2023 -
148. American Hospital Association: Medicare Advantage denials jump 56%
... payments from insurers. Others have noted that most MA carriers have faced allegations of billing fraud from the federal government and are being probed by lawmakers over their high denial rates. "It' ...21 November 2023 -
149. 2 physicians accused in $50M fraud scheme
Two Dallas physicians were charged with submitting $50 million in fraudulent claims to payers for corticosteroid injections and other services that were not performed and unlawfully distributing hydrocodone. ...21 November 2023 -
150. The future of claims management: How payers can maximize payment integrity
Recent statistics show that 7 to 10 cents of every dollar spent on healthcare goes toward paying for fraudulent claims. Meanwhile, the rise of value-based care and new technologies like ...20 November 2023 -
151. Pharmacy owners, physician convicted in $145M fraud scheme
Two pharmacy owners and a physician were convicted in a Texas federal court for their roles in a $145 million scheme to defraud the Labor Department through the submission of fraudulent claims for prescription ...20 November 2023 -
152. Medical equipment company owner pleads guilty to $20M fraud
The owner of two durable medical equipment companies pleaded guilty to conspiracy for his role in a kickback scheme that resulted in more than $20 million in fraudulent claims submitted to Medicare. Simon ...17 November 2023 -
153. How Olive AI ran out of time and money
... raised huge sums for societal transformation that was never delivered," the news outlet reported (though unlike Ms. Holmes, Mr. Lane has not been accused of fraud). Mr. Lane didn't respond to the publication' ...17 November 2023 -
154. 2 former NBA players convicted in healthcare fraud scheme
Two former NBA players were convicted for their roles in a scheme to defraud the league's healthcare plan out of $5 million, Bloomberg reported Nov. 15. Glen "Big Baby" Davis and William Bynum were ...16 November 2023 -
155. FTC's Lina Khan used ChatGPT to fight medical bil
... In May, Ms. Khan penned a roughly 1,000-word op-ed with The New York Times arguing that enforcers and regulators must be vigilant with AI. She said generative AI risks "turbocharging fraud," facilitating ...15 November 2023 -
156. Healthcare sharing ministry founder pleads guilty in $8M fraud scheme
... was the founder of Medical Cost Sharing and served as its CEO from 2014 through December 2022, according to a Nov. 14 Justice Department news release. He admitted to making false and fraudulent promises ...14 November 2023 -
157. Hospice owner convicted in $62M fraud scheme
The owner of a Louisiana hospice facility was convicted on all 23 counts against him for his role in a $62 million Medicare fraud scheme. Shiva Akula, MD, 67, of New Orleans, was the owner and operator ...13 November 2023 -
158. Kansas hospital fires CFO for allegedly lying about identity, fraud conviction
... during the interviewing/onboarding process," the memo stated. In 2005, the then-Mr. Brunton pleaded guilty in an Oklahoma federal court to one count of mail fraud for accepting a $3,775 check for college ...10 November 2023 -
159. Former Optum employee to pay $13M for role in fraud scheme
A former Optum employee will pay $13 million in restitution for his role in a multimillion dollar fraud scheme. According to a Nov. 9 news release from the Justice Department, Luke Steiner, who worked ...09 November 2023 -
160. Jakob Emerson, Associate News Director at Becker’s Healthcare
Jakob Emerson, Associate News Director at Becker’s Healthcare joins the podcast to discuss a former Medicare Advantage organization executive being charged in a multimillion dollar fraud scheme and an ...02 November 2023