Medicare Advantage Is Not Working As Intended
Medicare Advantage plans are raking in money. While some of it is due to politics, some of it is due to fraud.
Medicare Data is a Fraud-Fighting Resource
With Medicare data, whistleblowers and government investigators are better equipped to ensure government healthcare spending is medically necessary and reasonable.
The Billions Flowing From Pharma to U.S. Doctors
According to the above research, in recent years 67% of all US physicians received payments from the pharmaceutical industry.
How Private Equity is Changing the Face of American Healthcare
As we described last year, whistleblowers have been critical in monitoring private-equity-acquired medical providers for abusive and fraudulent behavior.
Why Telehealth Enforcement Remains a High Priority
Unfortunately, fraud permeated the telehealth program from the start of the pandemic and continues to plague an otherwise popular program for patients and their providers.
Whistleblowers Play Key Role in Exposing Medicare Advantage Fraud
While Medicare Advantage was supposed to be a less expensive alternative to traditional fee-for-service Medicare, it’s turned out to be more expensive.
RELEASE: Dept. of Justice Stats Spotlight the Importance of Declined False Claims Act Whistleblower Cases
54.5% of False Claims Act settlements and judgments in Fiscal Year 2022 were from declined whistleblower cases.
Electronic Health Records Ongoing Focus Of DOJ And HHS Enforcement
Since the eClinicalWorks settlement in 2017, the DOJ and HHS have focused on electronic health record vendors.
RELEASE: Fraud By The Numbers in 2022
As part of an ongoing effort to understand the impact of fraud, Taxpayers Against Fraud today released a new report on "Fraud By The Numbers in 2022."
What Does Fraud in the Medicare Advantage Space Mean for the Reverse False Claims Provision?
As the percentage of Medicare and Medicaid beneficiaries in managed care increases, there is a risk that fraudsters will misrepresent Medical Loss Ratios to the government.
