If we could call it upcoding, it would be an understatement to call it upcoding to infinity.
Fraud on Fridays
Fraud on Fridays: Fraud on Physicians in the ASC Setting
When you think about fraud at an ASC, you tend to think about fraud on payers, from Medicare to well, Blue Cross. You know, cases that never happened, patients who didn’t suffer from any medical issue, and the like. But what about fraud on physicians at an ASC? Because physicians hardly think about it, it…
Fraud on Fridays: $10.6 Billion – Does Crime Pay?
In a healthcare billing and payment system that’s so complex, it’s sad to say that criminals can stay a few steps ahead of the Feds. With $10.6 billion in bogus billing, some cutouts got caught, but the masterminds appear to have escaped with close to $1 billion.
Fraud on Fridays: The Four Legs of Fraud
The DOJ kicked back when it secured a conviction against compounding pharmacy executive Sam Glover for a six-year drug alteration and misbranding conspiracy involving free flowing prescription forms and, well, racehorses.
Fraud on Fridays: The Case of Dr. Jorge Zamora-Quezada
Dr. Jorge Zamora-Quezada, a Texas rheumatologist, was sentenced earlier this year to ten years in federal prison for a healthcare fraud so brazen it left even seasoned prosecutors shaking their heads. Read the full DOJ press release.
Fraud on Fridays: The BS MSO: Kickbacks Disguised as Investments Snare Another Round of Settlements
The Department of Justice just announced more than six million dollars in settlements with a former lab CEO, seven marketers, and two physicians. Their alleged wrong? Turning the concept of the “Management Services Organization” into a pay-to-play operation.