Tag: fraud

What if there was a way to detect fraud for SUD facilities?

Millions of Americans struggle with substance use disorder, with estimates suggesting as many as 1 in 13 people needed treatment in 2018. Between high demand for services and lack of regulation, this is an area of health care already rife with predatory behavior. Substance use disorder fraud was a significant problem before the COVID-19 pandemic, and it could potentially get even worse.

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COVID-19 and health care fraud

Colleagues Melissa Garrido and Michael Adelberg have published a piece on the Health Affairs blog about health care fraud pertaining to COVID-19. The COVID-19 epidemic

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Crowd sourcing fraud detection

Medicare and Medicaid have active fraud detection units that are setting records for recoveries. The HHS effort is not entirely in-house, but also partners with

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Massaging Medicaid

A week-and-a-half ago, the D.C. Circuit upheld the criminal conviction of the owner of a clinic that bilked Medicaid out of millions of dollars: [Jacqueline]

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The waste constituency

As is typical of his work, Uwe Reinhardt’s latest paper (ungated pdf) is an enjoyable read, quite accessible, and illuminating. [Patients] are both objects of

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Transparency as an anti-fraud tool

When Congress talks about “fraud and abuse” in health care, they inappropriately lump together two quite different categories. One are criminals who bill for services

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