Crackdown on Medicare fraud enforced by DOJ and HHS.
The Medicare Fraud Strike Force in Detroit recently arrested 53 suspects in Miami, Detroit and Denver including physicians, medical assistants, patients, company owners and executives on charges of conspiring to defraud the government program of reportedly $56 million.
According to the indictments, the defendants participated in schemes to submit claims to Medicare for treatments that were in fact medically unnecessary and oftentimes, never provided. In many cases, indictments allege that beneficiaries accepted cash kickbacks in return for allowing providers to submit forms saying they had received the unnecessary and not-provided treatments.
The multi-agency team of federal, state and local investigators designed to combat Medicare fraud through the use of Medicare data analysis techniques and an increased focus on community policing. The operations in Detroit are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a renewed effort announced in May 2009 between the Department of Justice and HHS to enforce current anti-fraud laws around the country.
Since March 2007, the Strike Force has obtained indictments of more than 250 individuals and organizations that collectively have billed the Medicare program for more than $600 million
Emerging Therapies Committee at UC Davis Hits the Accelerator Not the Brake | AMCP 2024
April 18th 2024After the onboarding of cell and gene therapy bogged using normal pharmacy and therapeutics (P&T) committee procedures, UC Davis Health set up an emerging therapeutics committee to streamline and speed up the process of delivery expensive cell and gene therapies.
Read More
DC Roundtable: Patrick Cooney of The Federal Group Drops the Latest on PBM Legislation in Washington
April 11th 2024In this episode of "DC Roundtable," Peter Wehrwein, managing editor of Managed Healthcare Executive, spoke with Patrick Cooney, president of The Federal Group, a lobbying and strategic planning firm in Washington, D.C., about recent developments in Washington concerning PBMs.
Listen
2024 Emerging Leaders in Healthcare — Submit For a Chance to Be Featured in MHE's August Issue
April 18th 2024MHE Editors are seeking diverse healthcare professionals from different backgrounds and healthcare sectors, with individual interests. Eligible candidates are early or mid-career leaders with less than 10 years of experience. Award winners will enjoy complimentary passes to the PBMI Annual National Meeting in Orlando, Florida, from Sept. 4-6. Additional perks include a feature in our August issue, a subscription to MHE and more!
Read More