Courtney Tito’s Post

Healthcare Fraud Shield will be at the Healthcare Payment & Revenue Integrity Series in Boston September 13-14. Come say hi! You can also sit in on our session "The Intersection of Payment Integrity & Fraud, Waste and Abuse" with sss. ss. s. s. s. s. s. s. s. s. s. s. s. s. s. s. s. s. s. s. s. s. s. s. s. s. s. s. s. s. s.. #hcfs #fwa #paymentintegrity

Healthcare fraud convictions can result in fines, restitution payments, imprisonment & professional repercussions like the loss of a medical license. Learn about the consequences of a healthcare fraud conviction and how to avoid them. https://lnkd.in/gSR_KDcg

Fraud is still rampant in Healthcare!!! 🙁 Highest Number of Settlements and Judgements in History!!! According to a February 2024 announcement made by the Department of Justice (DOJ), more than $2.68 billion in False Claims Act (FCA) settlements and judgments achieved this past fiscal year. From this total, over $1.8 billion related to matters that involved the health care industry, including managed care providers, hospitals, pharmacies, laboratories, long-term acute care facilities, and physicians. Health care fraud retains it’s first-place position as the leading source of FCA settlement and judgments. End of
Translation Read the press release and learn more about top settlements for Fiscal Year 2023. In the 2022 Health Care Fraud and Abuse Control (HCFAC) program report issued in November, 2023, the DOJ indicates the return is $2.90 for every $1 spent on investigations. With this kind of return on investment (ROI), the DOJ will continue aggressively pursuing health care fraud and abuse. #healthcarefraud #fca #doj

Does it surprise you that a whopping $1.8 billion in healthcare fraud settlements and judgments were reached under the False Claims Act in 2023 alone? 💰 This eye-opening figure underscores the crucial role of whistleblowers and skilled healthcare fraud attorneys in uncovering and prosecuting fraudulent activities in the healthcare industry. Discover the benefits of partnering with a whistleblower attorney and learn how reporting fraud can lead to substantial rewards in our latest blog post. 🔗 Check it out here: https://bit.ly/4atTucn If a whistleblower's case is successful, they could earn a reward of up to 30% of the funds recovered by the government. #healthcarefraud #whistleblowerattorney #whistleblowerlawfirm #whistleblower

Today’s Compliance Journey piggybacks off yesterday’s topic of Enforcement. Fraud, Waste, and Abuse Laws (FWA) The Government agencies enforcing these laws include the Department of Justice, the Department of Health & Human Services Office of Inspector General (OIG), and the Centers for Medicare & Medicaid Services (CMS). There are five major healthcare fraud, waste, and abuse laws that healthcare organizations need to be aware of: The False Claims Act (FCA), the Anti-Kickback Statute (AKS), the Stark Law, the Exclusion Authorities, and the Federal Civil Monetary Penalties Law (FCMP). Healthcare organizations can help reduce fraud, waste, and abuse by having an Effective Compliance Program to ensure they can cost-effectively provide quality care. https://lnkd.in/gkMQDyWE #compliancejourney #compliance #fraudwasteandabuse

Medicare fraud is a serious issue that affects both consumers and businesses. To protect yourself and your business, it's important to be aware of common fraud schemes and take preventive measures. For consumers, be wary of providers who offer services or equipment that you didn't request, and always review your Medicare Summary Notice for errors. Never give your Medicare number to anyone other than your healthcare provider. For businesses, implement strict billing and coding guidelines, conduct regular audits, and educate employees about Medicare fraud. Encourage employees to report any suspicious activity. By being vigilant and proactive, we can all help combat Medicare fraud and ensure that resources are used appropriately. Share these tips with your friends and colleagues to raise awareness! #MedicareFraudProtection #ConsumerSafety #BusinessIntegrity

Discovering fraudulent activities in healthcare is crucial to ensuring the integrity of the system. In this article, we explore one of the most common healthcare fraud schemes--Risk Adjustment Factor (RAF) score inflation. In addition, the article highlights the importance of reporting fraudulent activities and how to do it. Not only does reporting fraud help maintain the integrity of the healthcare system, but it also offers a potential reward for whistleblowers of up to 30% of the funds recovered. Don't miss out on the opportunity to make a difference and earn a reward by shedding light on healthcare fraud. Read on to learn more! https://bit.ly/3NzArFf #djowhistleblowerlawgroup #healthcarefraud #whistleblower #riskadjustment

It's Medicare fraud. And, like, a federal crime, for reals. Showtime's Billions collides with my passion. In its final season, Billions addresses my favorite topics: Medicare Fraud. False Claims Act. Healthcare Fraud. Wire Fraud. Wendy: Explain the outsized revenue despite the skeletal staff of doctors. Rian: Mental's been billing insurers for its A.I. check-ins as if they're actual human sessions. Wendy: So our big strength, automated therapy, it's actually a big scam? Rian: It's Medicare fraud. And, like, a federal crime, for reals. - Billions Season 7 Episode 10: "Enemies List" #healthcarefraud #medicare #falseclaimsact #wirefraud #fraud Advize

In 2023, the Department of Justice and the Federal government settled a record breaking $2.7 billion in False Claims Act cases, $1.8 billion related to healthcare cases - fraud and abuse. False Claims cases under Medicare are a large risk for providers today, especially given the perils of billing for substandard care, overbilling for care not deemed medically necessary or for care not substantiated by documentation to support the claim. More specifics on this issue, here: https://lnkd.in/gA3RNMHz

My article has officially been published with George Mason International Law Journal! I have to extend a huge thank you to the entire ILJ team for helping me with my article and working so diligently to get to it ready for publication. This article allowed me to research and explore my interests of global health and international law while considering the government structures of the United States and European Union countries to combat healthcare fraud. To read my article, click the link below!