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21

Fraud Doesn’t Pay for Healthcare Providers

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Fraud Doesn’t Pay for Healthcare Providers
An EHR vendor recently agreed to pay over $57 million to resolve allegations that it had caused its users to submit false claims to the government. With other recent Justice Department cases, it has become clear that this is not a unique occurrence. Fraud can happen at any type of healthcare organization, and the penalties are always high. Between fines, settlement agreements, exclusion from federal programs, and jail time, one thing is clear: fraud is not worth it.
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| Categories: AIHC Professional Articles | Tags: DOJ, OIG, Providers, Compliance, Audit, Forensic Audit, Health Care Fraud, Billing, EHR, Healthcare Employees, Training, Healthcare Payers, Medicare and Medicaid, False Claims Act, Anti-Kickback Statute, Stark Law | View Count: (135)
By Yolanda del Valle Legal Compliance This article looks at the six motivating reasons that tend not to work with Compliance; there are others, but those set out below are the most frequent. Some days ago, I made use of a business trip to get some time to myself – something that’s difficult to come by […]
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| Categories: Compliance | Tags: Compliance, compliance, compliance management system, Fraud, organizational compliance, risks | View Count: (15)
11

The Need for Internal Forensic Healthcare Auditors

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The Need for Internal Forensic Healthcare Auditors
The exponential growth of technology and the internet, while facilitating patient care and providing uninterrupted accessibility of information, has opened doors to new risks. Perhaps the biggest risk of all is health care fraud. Internal forensic healthcare auditors play a key role in the detection and prevention of these fraud schemes, and therefore require specialized training to investigate instances of suspected health care fraud, such as medical identity theft.
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| Categories: Compliance, AIHC Professional Articles, AIHC Free CEU Articles | Tags: CMS, Medicare and Medicaid, Compliance, Audit, Forensic Audit, Health Care Fraud, Continuing Education | View Count: (1410)
By Adam Turteltaub adam.turteltaub@corporatecompliance.org Rashmi Airan won’t be addressing health care compliance issues at the 2018 Compliance Institute.  Instead, she’ll be talking about her career as an attorney with a great deal of real estate experience, particularly in questionable transactions.  Those transactions resulted in a guilty plea and approximately six months in prison. In this […]
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| Categories: Compliance | Tags: Compliance, Podcasts, compliance, Compliance Institute, ethics, Fraud, rashmi airan, real estate | View Count: (309)
17

Fraud: An Issue in Healthcare and Beyond

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Fraud: An Issue in Healthcare and Beyond
This week is International Fraud Awareness Week! What can your organization do to combat healthcare fraud and abuse?
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| Categories: Compliance, AIHC Professional Articles, AIHC Free CEU Articles | Tags: CMS, HHS, DOJ, Medicare and Medicaid, Compliance, Audit, Forensic Audit, Health Care Fraud, Continuing Education | View Count: (1022)
What to Do After Detecting Fraud, Abuse, or Criminal Activity
What happens when a routine audit reveals signs and symptoms or potential fraud, abuse or even criminal activity? There is a remedial step that many organizations are not prepared to address properly: conducing formal internal investigations and forensic audits.
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| Categories: Compliance, AIHC Professional Articles | Tags: Compliance, Ethics, Health Care Fraud, Audit, Forensic Audit, HIPAA, HIPAA Covered Entities, EHR | View Count: (372)
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Articles written by the American Institute of Healthcare Compliance are under Copyright Notice: © 2016-2019 American Institute of Healthcare Compliance, Inc. All Rights Reserved. Views expressed through RSS feeds or remarks made on this blog or website are solely those of the original authors and other contributors and do not necessarily represent those of the American Institute of Healthcare Compliance and/or staff.