Fraud Follies

[MM Curator Summary]: It took them 5 years, but SEIU successfully got $20M in Medicaid-funded union dues restored.    The
[MM Curator Summary]: An Iowa referral agency double-billed the state for services over a 4 year period.    The article
[MM Curator Summary]: A substance abuse provider is suing its software vendor, claiming the software vendor is at fault for
[MM Curator Summary]: Springbok Health will pay up to $335k for upcoding simple services to get paid as if they
[MM Curator Summary]: Two LA mental health providers stole $3.5M from Medicaid by paying members to enroll in their program
[MM Curator Summary]: The corrupt inclusion of union-boss graft in Medicaid contracts remains in the latest version of Medicaid health
[MM Curator Summary]: Th NY Comptroller continues to find extensive improper Medicaid payments in the Medicaid program year after year.
[MM Curator Summary]: BayCare and several other Florida hospitals are paying up in a whistleblower suit that shows them gaming
[MM Curator Summary]: Jennifer McGevna was arrested for submitting false claims for mental health services in CT.    The article
[MM Curator Summary]: Pamela Bell falsified claims to make it look like her mental health company was using licensed therapists.
[MM Curator Summary]: Jessica Brown and Shonna Marshall have been convicted of using a ghost company to steal NV Medicaid
[MM Curator Summary]: Compassionate Homecare execs stole $6.5M from MA Medicaid with an un-authorized services scam.    The article below
[MM Curator Summary]: A proposed federal law would expand efforts to ensure Medicaid benefits do not go to those eligible
MM Curator summary [MM Curator Summary]: A WY behavioral health provider team has been acquitted, but the damage to their
   MM Curator summary [MM Curator Summary]: The drug company depressed rebates it should have paid to Medicaid and set
MM Curator summary [MM Curator Summary]: The lab was charging CT Medicaid4x what it was charging other payers for urine
   MM Curator summary [MM Curator Summary]: A recent ruling may bring a harsher treatment of Medicaid fraud, including a
MM Curator summary [MM Curator Summary]: A behavioral health provider was convicted for submitting false claims and ordered to pay
MM Curator summary [MM Curator Summary]: Payments determined by CMS to be improper range from 22%-37% across states reviewed.  
MM Curator summary [MM Curator Summary]: A Florida hospital was "donating" services, but then getting federal matching dollars for them,
MM Curator summary [MM Curator Summary]: A very large member fraud involved family members switching roles back and forth between
MM Curator summary [ MM Curator Summary]: A NJ nursing home operator is on the run from the law.  
MM Curator summary [ MM Curator Summary]: Academy Health must pay back hundreds of thousands of dollars AND stop operations.
MM Curator summary [ MM Curator Summary]: The Empower story gets deeper.    The article below has been highlighted and
MM Curator summary [ MM Curator Summary]: A GA counselor stole more than $600,000 from Medicaid using fake documentation in
MM Curator summary [ MM Curator Summary]: Almost 22% of Medicaid payments are made in error according to the latest
[ MM Curator Summary]: 3 recent audits of the NY Medicaid program show significant preventable losses.
MM Curator summary [ MM Curator Summary]: 2 women who set up an entire shadow company solely for the purpose
[ MM Curator Summary] 2 NY NET dispatchers routed trips to a company owned by a person they colluded with
MM Curator summary    TN Medicaid paid almost $5M for fake visits at a primary care clinic.    The article
MM Curator summary    14 US Senators are asking CMS head Lasure to explain the plan to get a handle
MM Curator summary    The provider was using unlicensed workers at its mental health facilities.    The article below has
MM Curator summary    The latest report shows the state pays claims without required provider ids.    The article below
MM Curator summary    A new audit finds various issues with payment integrity in KS Medicaid, some of which have
MM Curator summary A new audit in MS shows members are getting enrolled even when they are ineligible due to
MM Curator summary The latest audit of Philadelphia Medicaid payments shows egregious issues that the mayor is dismissing.    The
MM Curator summary    CMS has been sued for not providing information about what its doing to reduce improper payments
MM Curator summary    A MO behavioral health provider has successfully fought back $2M of services-not-provided allegations.    The article
MM Curator summary    A home care agency stole $300k in taxpayer dollars using falsified billing records.    The article
MM Curator summary    CMS did not use a method recommended by OIG for preventing payments to providers known to
MM Summary - An Arizona government employee ran an illegal adoption scheme that paid pregnant immigrants to come to the
MM Summary - A TX hospice stole $1.8M using a provider kickback scheme.    The founders of Texas-based Allstate Hospice
MM Summary - An Ohio man awaits trial for stealing $2M from Medicare and Medicaid by billing for X-ray services
MM Summary- A medical equipment company stole $40M from Florida Medicaid by billing for unnecessary ventilators.       Apria Healthcare,
MM Summary- A Maryland woman stole $250,000 from D.C. Medicaid by submitting false timesheets for home care services.     
MM Summary - A NY couple hid their income so they could get SNAP benefits and stole $17,000.00     
MM Summary- A Mississippi man stole $287M from Tri-Care using his compounding pharmacy scheme to get paid for prescriptions that
MM Summary- A TX man submitted fake claims for ambulance services that were not provided and stole $664,000 from Medicare
MM Summary- A Virginia state employee falsified her own Medicaid application and received $1,800 of medical services.       A
Curator summary - Alex Fleyshmakher (Bronx) operated a kickback scheme where he paid doctors to send patients to his pharmacies
A special treat for all your fraud lovers.
MM Curator summary    TN mother falsely reported she had custody of her so that she could get Medicaid benefits.
MM Curator summary    A group of TN doctors got paid by Medicare and TN Medicaid for an implantable acupuncture
MM Curator summary    A New Mexico personal care agency owner falsified billings for her employees.       The article
MM Curator summary:    Peter Khaim and Arkadiy Khaimov (NYC) stole $30M from Medicaid using billing override codes during the
MM Curator summary:    MA homecare company (Maestro) stole $10M from Medicaid billing for services that had not been authorized
MM Curator summary:    Steven Yohay of Brooklyn paid homeless New Yorkers to admit into his rehab facilities, stealing $3M
MM Curator summary:    Trump pardoned the Miami fraudster behind a $1.3B Medicare and Medicaid fraud scheme.    The article
MM Curator summary:    Rebecca Fruge fraudulently billed $76,000 for in home medical services for times her client was in
MM Curator summary:    A Kentucky dentist plead guilty to stealing $70,000 from Medicaid in an upcoding scheme.    The
MM Curator summary:    A surgeon and his office manager billed Medicare and Medicaid for more than 3,000 surgeries that
MM Curator summary:    A Kentucky dentist plead guilty to stealing $70,000 from Medicaid in an upcoding scheme.    The
MM Curator summary:    Charlz and Angela Bisong of Texas paid Medicare members to sign up for unneccessary services so
MM Curator summary    COVID has driven a dramatic surge in Louisiana Medicaid enrollment, but the current DHS Director says
Texas releases its annual report of fraud recoveries made my Medicaid health plans. Clipped from: https://oig.hhsc.texas.gov/sites/default/files/documents/annual-report-on-certain-fraud-and-abuse-recoveries-fy-2020.pdf    
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
CA, Fraud    The article below has been highlighted and summarized by our research team. It is provided here for
Fraud, TN, Behavioral Health The article below has been highlighted and summarized by our research team. It is provided here
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as
Curator, Roundtable Show, Fraud, Waste and Abuse  The article below has been highlighted and summarized by our research team. It