fraud

Top five strategies for managing post-acute carePlans must be able to deploy these five tactics, whether using internal resources or collaborating with a vendor.
Pharmacy ordered to repay nearly $1 million to Medicaid
Pharmacy ordered to repay nearly $1 million to MedicaidAn independent community pharmacy was busted in a Medicare fraud investigation.
New healthcare fraud trends managed care organizations need to watchNew healthcare fraud schemes are emerging. Here are a few of the most noteworthy.
Creative marketing or deceptive advertising?Dr. Ad employs a variety of advertising methods to grow his practice. Two years ago, he ran an ad that said prolonged use of his $1,000/tube facial cream would negate a need for a facelift. Now he is facing a complaint by a patient who bought 20 tubes and saw no improvement over the course of a year. Dr. Ad claims that his marketing was harmless and no different than most other ads. Is he in trouble?
Pharmacists Charged in Health-Care Fraud Schemes
Pharmacists Charged in Health-Care Fraud SchemesTwo pharmacists were charged in two different fraud cases.
Two Pharmacists Involved in Multimillion Dollar Scam
Two Pharmacists Involved in Multimillion Dollar ScamA compounding fraud scheme cost taxpayers millions—and could put two pharmacists in prison.
Retina surgeon’s AMD regimen at center of Medicare fraud case
Retina surgeon’s AMD regimen at center of Medicare fraud caseEarlier this month, a jury convicted West Palm Beach retina surgeon Solomon Melgen, MD, on 67 counts of Medicare fraud. This high-profile case hit very close to home, as myself and another retina specialist from my own community were on opposing sides of the case.
Inside the $100 Million Opioids Ring
Inside the $100 Million Opioids RingHow physicians made millions and fed the opioid epidemic.
12 ways to prevent embezzlementTwo out of every five small businesses are victims of employee embezzlement, and most of these crimes are perpetrated by employees who had been with the company one to five years, have a college degree, and have access to the company’s accounting records.
How to Safeguard Against Fraudulent PrescriptionsRed flags—and what to do when your suspicions are aroused