Compliance & Legal

From 2010 to 2013, Paula Kluding concealed the true medical condition of Prairie View Hospice's patients in order to "pass" a Medicare audit and to fraudulently obtain money from Medicare, according to evidence presented at trial.

Sadiq created fake patient files to fool a Medicare auditor by making it appear as if home health services were provided and medically necessary.

The Centers for Medicare and Medicaid Services is falling short in busting potential fraud by not verifying physician addresses and making sure they are currently licensed, according to a new Government Accountability Office report.

System's president calls for immediate retraction of a Centers for Medicare and Medicaid report alleging discriminatory practices by Health Sciences Center-Shreveport and its physicians in the delivery of patient care

Beyond potential fines are the price of making sure the hospital is in compliance and the unquantifiable cost of the loss of reputation and trust.

The Fraud Prevention System uses predictive analytics to identify questionable billing patterns in real time.

Farid Fata admitted to prescribing and administering unnecessary aggressive chemotherapy, cancer treatments and infusion therapies to patients to increase his billings to Medicare and private insurance companies.

Pennsylvania-based Geisinger has developed five major bodies of oversight, each headed by a senior executive, and a centralized compliance office.

$12 million healthcare fraud case in Houston

The Centers for Medicare & Medicare Services is calling on doctors, hospitals and health professionals to participate in a new aspect of the federal government's Million Hearts program, a national initiative to prevent 1 million heart attacks and strokes between 2012 and 2017.