Jun 15, 2025 | False Claims Act, Fraud Investigations, Government Investigations, Health Care, Health Care Fraud, Medicare and Medicaid, White Collar Crime
Last month, North Carolina Attorney General Jeff Jackson announced that his office had reached a consent judgment of over $4.7 million with Kernersville-based healthcare provider Steven Osbey to resolve an alleged Medicaid fraud scheme. 💰 What Happened According to...
Jun 7, 2025 | False Claims Act, Government Investigations, Health Care, Health Care Fraud, Medicare and Medicaid
On June 3, the United States Attorney’s Office for the Southern District of Florida in Miami announced that it had filed a complaint under the False Claims Act (FCA) against Florida-based medical billing company AIMA. According to the DOJ’s complaint,...
Mar 24, 2025 | Administrative Law, Health Care, Medicare and Medicaid, Overpayment Appeals
Because Medicare processes over one billion fee-for-service claims annually, it is impossible for CMS and its contractors to review every claim – or even a substantial percentage of claims – on a pre-payment basis. Accordingly, Medicare has set up various...
Feb 20, 2025 | DMEPOS, Government Investigations, Health Care, Health Care Fraud, Medicare and Medicaid
If you are a DMEPOS supplier and are purchasing opt-in Medicare leads, you should be aware of Medicare’s prohibition against telephone solicitation of beneficiaries. In order to enroll as a Medicare DMEPOS supplier, and as a condition of payment, DMEPOS providers must...
Nov 11, 2024 | Health Care, Medicare and Medicaid
When the Affordable Care Act was passed and signed into law by President Obama in 2010, one of its provisions required Medicare providers and suppliers to report and refund Medicare overpayments within 60 days of “identifying” such an overpayment. Violating this...
