CMS Fraud War Room: Strengthening Oversight Through Real-Time Compliance Action
The Centers for Medicare & Medicaid Services (CMS) Fraud War Room serves as a central command center for real-time oversight,…
Darius Hall Promoted to IT Manager
We are excited to announce the promotion of Darius Hall, CISSP, to IT Manager. Since joining the team as a…
Enforcement Update on Medicaid Fraud Control Units
Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and cases involving patient abuse or neglect. They play…
Rapid Increases in Home Health Agency Fraud
Key Points: Home Healthcare Agencies (HHAs) continue to be among the fastest-growing sectors in healthcare, as well as among the…
Hospice Fraud Enforcement
Key Points: Hospice is one of the most frequently targeted sectors of health care. Hospice organizations are under increasing legal…
Court Ruling Tightens Requirements For False Claims Act Cases Based On The Anti-Kickback Statute
In 2010, Congress amended the Anti-Kickback Statute (AKS) to state that claims “resulting from” an AKS violation are “false or…
OCR Guidance on Defending Against Common Cyber-Attacks
The number of reportable breaches of unsecured electronic protected health information (ePHI) affecting more than 500 individuals increased 45 percent…
Reminder That COVID-19 Fraud and Related Schemes Still Abound
Key Points: DOJ and OIG continue to issue warnings about fraud schemes. Consumers should remain alert. The Department of Health…
Phishing Attacks Remain A Serious Compliance Threat
Key Points: Data breaches are on the rise. Tips for compliance officers to counter information security threats are included below.…
Medicaid Fraud Control Units: 2020 Results
Key Points: The OIG reported that MFCUs recovered more than $1 billion in Fiscal Year 2020. MFCUs evidenced a return on…
Subjects Sentenced in $150 Million Hospice Fraud Case
3 Categories of Hospice Fraud The three major categories of hospice fraud are: (1) false claims for unnecessary, improperly delivered,…
New FBI Internet Crime Report
Key Points: The report includes COVID-19 scam and state-level statistics. Tips for preventing attacks are included below. The Internet Crime…