HHS Office of Inspector General’s Post

🚨 Reporting fraud take integrity and courage. An act that can save policyholders and carriers significant costs. The National Health Care Anti-Fraud Association estimates the financial losses from health care fraud range from 3-10%. IASIU stands beside the whistleblowers and individuals who report fraudulent activities. Learn how to report fraud and make a difference in the fight against fraud. #ReportFraud #WhistleblowerProtection

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

The week of June 5 marks Medicare Fraud Prevention Week. End of
Translation Seniors – as well as their caregivers – should be aware of the risks posed by Medicare scams and how to avoid falling victim to this type of fraud. #ElderLawAnswers #MedicareFraudPreventionWeek #Medicare

The U.S. Justice Department's recovery of $2.69 billion in False Claims Act cases in 2023, with $1.8 billion of that tied to healthcare fraud, underscores the ongoing battle against fraudulent activities in the healthcare sector. For healthcare providers, these numbers serve as a reminder of the importance of maintaining strict compliance measures to prevent fraudulent practices. Failing to do so not only jeopardize financial stability but also tarnishes reputations and erodes patient trust. It is always interesting to me to see these statistics every year and see how healthcare fraud dominates recoveries. #HealthcareFraud #FalseClaimsAct #ComplianceMatters

Don't let your organization get caught up in something like this... Two Telemedicine Companies Plead Guilty in Multi-Million Dollar Medicare Fraud Scandal CliffNotes: Jean Wilson, Owner of both companies, orchestrated a scheme involving medically unnecessary orthotic braces and drugs to submit fraudulent claims She pled GUILTY to conspiracy to commit health care fraud and wire fraud and faces up to 20 Years in prison and agreed to restitution payment of $66 Million to Medicare and the IRS Who's Handling the Case: The HHS-OIG, FBI, and IRS-CI are investigating the case. Link to article in comments>>> #healthcarefraud #telehalth #regulatory #medicare

Medical identity theft is when someone steals or uses your personal information (like your name, Social Security number, or Medicare number), to submit fraudulent claims to Medicare and other health insurers without your authorization. When it comes to preventing medical identity theft, healthcare providers play an important part in safeguarding protected health information (PHI). Here are some steps you can take as a healthcare professional to reduce the likelihood of this crime affecting you or your patients. #medicalidentitytheft #identitytheft

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 were 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. 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

When I was an AUSA, I always found the "National Health Care Enforcement Action" day to be odd. Health care fraud occurs every day and charges should be brought when the prosecution team is ready - not on a contrived "Enforcement Day." Nevertheless, the annual enforcement day announcement does provide a window into current DOJ priorities. This year, it is (1) telemedicine fraud, particularly regarding orthotic braces and pain creams, (2) reselling of illegally-obtained pharmaceuticals, and (3) medically unnecessary prescribing and billing associated with opioids. These have been hot enforcement areas for years with no end in sight. https://lnkd.in/eb7CCCYh #healthcarecompliance #healthcarefraud #doj

Are you aware of the benefits of being the first to file a whistleblower claim in healthcare fraud? Being the first to file a claim can impact your potential to earn a reward of up to 30% of the funds recovered. To take action today and fight against healthcare fraud, read our latest article https://bit.ly/3IhQRyR. #djowhistleblowerlawgroup #healthcarefraud #firsttofile