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161. 'A short-term trend that is going to backfire': Will hospitals regret their Medicare Advantage divorce
... pointed to allegations of billing fraud among MA carriers made by the federal government. "It's become a game of delay, deny and not pay,'' Chris Van Gorder, president and CEO of San Diego-based Scripps ...31 October 2023 -
162. Healthcare billing fraud: 10 recent cases
From the arrest of the former leader of Arkansas' medical board, to a former executive of HealthSun Health Plans accused of orchestrating a multimillion-dollar scheme, here are 10 healthcare fraud cases ...30 October 2023 -
163. Medical marketer convicted in $55M fraud scheme
A medical marketer was convicted by a federal jury in Texas for his role in a $55 million scheme that defrauded Tricare and other federal healthcare programs. Quintan Cockerell, 42, of Palos Verdes ...27 October 2023 -
164. Medical supply company owner pleads guilty to $2M Medicare fraud scheme
A Virginia medical equipment company owner pleaded guilty to conspiring to defraud Medicare. Julian Latty operated Beach Medical Suppliers with a co-conspirator, Jordan Thomas Broome, according to ...27 October 2023 -
165. California system 'considering all options' after losing $9.5M termination cas
... Mr. Stiver "with malice, oppression or fraud." In May, the defendants were ordered to pay $4.95 million for lost compensation and $5 million for punitive damages. The sum was lowered to $9.475 million in ...26 October 2023 -
166. 10 indicted in $20M black-market HIV medication fraud scheme
Ten people have been indicted in an alleged scheme that defrauded Medicaid, Medicare and private insurance companies out of at least $20 million by trafficking black-market HIV medication. The scheme ...25 October 2023 -
167. Louisiana physician pleads guilty in $5.6M fraud scheme
A Louisiana physician pleaded guilty to defrauding Medicare out of $5.6 million by ordering medically unnecessary durable medical equipment and cancer genetic testing. Alex Glotser, MD, 36, of Metairie, ...25 October 2023 -
168. CEOs' deception is not fooling AI
... on earning calls. Their findings were published Sept. 11 in the Strategic Management Journal. The study focused on fraudulent financial statements. So far, AI is 84% accurate when identifying business ...25 October 2023 -
169. Wyoming nurse pleads guilty in $6M healthcare fraud
A Wyoming nurse pleaded guilty to conspiracy to commit healthcare fraud in a $6.1 million healthcare scheme in Idaho. Kristen Bolling, RN, 40, is a licensed nurse practitioner in Wyoming, Colorado ...24 October 2023 -
170. Dialysis providers to pay $9.5M to settle billing fraud allegations
Several dialysis providers agreed to pay more than $9.5 million to settle allegations they double billed Medicaid for certain medications. The government alleged that from 2000 through 2010, the dialysis ...23 October 2023 -
171. Physician seeks plea deal in opioid scheme to drop patient death charges
A New York physician pleaded guilty to counts of unlawful distribution of opioids and healthcare fraud, the Adirondack Daily Enterprise reported Oct. 23. Duane Dixon, MD, 64, was a pain medicine specialist ...23 October 2023 -
172. 11 recent hospital lawsuits, settlements
... off the market. 4. Rockville Centre, N.Y.-based Catholic Health of Long Island will not have to defend allegations it fraudulently diverted a nursing home's service payments to another facility while ...23 October 2023 -
173. Silicon Valley exec gets 8 years in prison for fraud, kickback scheme
Mark Schena, former president of medtech company Arrayit Corp., on Oct. 18 was sentenced to eight years in prison and ordered to pay $24 million in restitution for defrauding investors and paying illegal ...19 October 2023 -
174. Hospitals sour on Medicare Advantage: 8 things to know
... denial rates and slow 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 ...17 October 2023 -
175. Why healthcare CFOs are eyeing Venmo, Zelle
... product at U.S. Bank. "And educating patients on the benefits, as well as the security of digital payments, is also important. We hear a lot about fraud, so educating patients about the safety of digital ...17 October 2023 -
176. Catholic Health prevails in Medicare fraud case
Rockville Centre, N.Y.-based Catholic Health of Long Island will not have to defend allegations it fraudulently diverted a nursing home's service payments to another facility while certifying compliance, ...17 October 2023 -
177. Former physician leader arrested amid fraud allegations, 40 patient lawsuits
Brian Hyatt, MD, the former leader of Arkansas' medical board, was arrested Oct. 9 for alleged Medicare fraud. Dr. Hyatt is also facing lawsuits from more than 40 former patients accusing him of holding ...10 October 2023 -
178. California lab owners plead guilty to $359M COVID test fraud scheme
... guilty to conspiracy to commit healthcare fraud. Ms. Navarro pleaded guilty to conspiracy to commit healthcare fraud and wire fraud and faces up to 20 years in prison. Both are scheduled to be sentenced ...06 October 2023 -
179. Pharmacy owner pleads guilty to $25M healthcare fraud scheme
A Great Neck, N.Y., man pleaded guilty to conspiring to defraud Medicare and Medicaid of more than $25 million. Between January 2015 and December 2022, Dacheng Lu, formerly a part owner of New York ...06 October 2023 -
180. Convicted lab owner ordered to forfeit $187M in fraud proceeds
A Georgia lab owner convicted for his role in a $463 million fraud scheme was ordered to forfeit more than $187 million in fraud proceeds. Minal Patel, 44, owner of LabSolutions, was sentenced in August ...04 October 2023