Sentences with phrase «for health care fraud»

About 1,400 individuals are indicted in federal court for health care fraud every year and more than 2,500 individuals are currently being investigated for Medicare fraud.

Not exact matches

Driving Down Health Care Costs (Panel Publishers, New York City, 1991, $ 89), a collection of 44 articles, is a simple way to tap into savvy strategies currently recommended by insurance and benefits practitioners to reduce insurance fraud, audit for cost savings, redesign retiree benefits, and more.

«From loansharking and illegal gambling, to credit card and health care fraud, and even firearms trafficking, today's mafia is fully diversified in its boundless search for illegal profits,» Manhattan U.S. Attorney Preet Bharara said in a statement.

«From loansharking and illegal gambling, to credit card and health care fraud, and even firearms trafficking, today's mafia is fully diversified in its boundless search for illegal profits.

Medicare supports home health services including visiting nurses and therapy, but according to Steven Landers, MD, MPH, clinical associate professor at Rutgers Robert Wood Johnson Medical School, the current policy should be strengthened to limit fraud, provide consistent services nationally to reduce health disparities and allow for better care coordination.

Ultimately, the fraud raises health care costs for everyone.

This year another effort by Canine Health Concern in the UK is once again trying to stop the unethical marketing of vaccine protocols that are not within the standard of care for veterinary medicine and constitute fraud.

You are instructed to appear in court to be on a panel of 60 potential jurors in a health care fraud case but, I mean, damn — you don't have time for that nonsense!

White collar crime is a generic term for crimes involving antitrust violations, computer / internet fraud, credit card fraud, phone / telemarketing fraud, bankruptcy fraud, health care fraud, environmental law violations, insurance fraud, mail fraud, government fraud, tax evasion, financial fraud, securities fraud, insider trading, bribery, kickbacks, counterfeiting, public corruption, money laundering, embezzlement, economic espionage, and trade secret theft, and other forms of dishonest business schemes.

Some people believe that situations like this carry a potential for fraud — the health care provider gets clients directly from the lawyer, so they might have an interest in increasing the treatment or bills in order to increase the case value and to receive more referrals from that lawyer.

A 70 - year - old Boca Raton man was sentenced to five years in prison for $ 63 million in home health care fraud.

Defeated class certification in potential multi-million dollar health care consumer fraud action, then resolved for exceptionally favorable value during the appeal.

Represented a health care system in South Texas in a lawsuit against former insurance agents for violations of the Texas Insurance Code, violations of the Texas Theft Liability Act, conversion, fraud, fraud by non-disclosure, negligent misrepresentation, and breach of contract.

This webinar provided an introduction to the Stark law, the Anti-Kickback Statute, the False Claims Act, and other health care fraud and abuse laws; reviewed common compliance issues that arise under these laws; and discussed the range of penalties for noncompliance with such laws.

Selesnick and Medina also defend providers in government investigations for fraud and abuse, and routinely represent health care providers in complex business disputes.

Whether you've been charged for credit card fraud, check fraud, broker fraud, health care fraud, foreclosure fraud or any other type of fraud, you need to contact a central California criminal defense attorney from McKneely Law Firm.

Health Law Diagnosis reports and examines issues across a broad array of topics, including fraud and abuse, government enforcement, Medicare and Medicaid, reimbursement, hospitals and health systems, pharmaceuticals, medical devices, and other important areas for the health care and life sciences indusHealth Law Diagnosis reports and examines issues across a broad array of topics, including fraud and abuse, government enforcement, Medicare and Medicaid, reimbursement, hospitals and health systems, pharmaceuticals, medical devices, and other important areas for the health care and life sciences indushealth systems, pharmaceuticals, medical devices, and other important areas for the health care and life sciences indushealth care and life sciences industries.

As an Assistant U.S. Attorney, he prosecuted several health care fraud cases and tried the first criminal anti-kickback health care case to a jury verdict in the U.S. District Court for the Middle District of Florida.

He handles matters for clients involving: Medicare and Medicaid program certification, coverage, billing, and payment; hospital, physician, and other provider transactions; fraud and abuse; compliance; internal and external audits; disclosures and repayments; graduate medical education accreditation and payment; physician and non-physician practitioner scope of practice, coverage, coding and billing; and federal health care legislation and rulemaking.

The commenters identified particular factors that could lead to confusion, including that (1) the phrase «criminal, civil, or administrative proceeding» appeared in the definitions of both law enforcement Start Printed Page 82673and oversight; (2) the examples of oversight agencies listed in the preamble included a number of organizations that also conduct law enforcement activities; (3) the NPRM addressed the issue of disclosures to investigate health care fraud in the law enforcement section (§ 164.510 (f)(5)-RRB-, yet health care fraud investigations are central to the mission of some health care oversight agencies; (4) the NPRM established more stringent rules for disclosure of protected health information pursuant to an administrative subpoena issued for law enforcement than for disclosure pursuant to an oversight agency's administrative subpoena; and (5) the preamble, but not the NPRM regulation text, indicated that agencies conducting both oversight and law enforcement activities would be subject to the oversight requirements when conducting oversight activities.

Because we consider both of these activities to be critical national priorities, we do not require covered entities to obtain authorization for disclosure of protected health information to law enforcement or health oversight agencies — including those oversight activities related to health care fraud.

To clarify further that health oversight disclosure rules apply generally in health care fraud investigations (subject to the exception described above), in the final rule, we eliminate proposed § 164.510 (f)(5)(i), which would have established requirements for disclosure related to health fraud for law enforcement purposes.

In such cases, where the individual is the subject of the investigation and the investigation does not relate to health care fraud, identified as investigations regarding issues (a) through (c), the rules regarding disclosure for law enforcement purposes (see § 164.512 (f)-RRB- apply.

Fourth, in § 160.203, several criteria relating to the statutory grounds for exception determinations have been further spelled out: (1) The words «related to the provision of or payment for health care» have been added to the exception for fraud and abuse; (2) the words «to the extent expressly authorized by statute or regulation» have been added to the exception for state regulation of health plans; (3) the words «of serving a compelling need related to public health, safety, or welfare, and, where a standard, requirement, or implementation specification under part 164 of this subchapter is at issue, where the Secretary determines that the intrusion into privacy is warranted when balanced against the need to be served» have been added to the general exception «for other purposes»; and (4) the statutory provision regarding controlled substances has been elaborated on as follows: «Has as its principal purpose the regulation of the manufacture, registration, distribution, dispensing, or other control of any controlled substance, as defined at 21 U.S.C. 802, or which is deemed a controlled substance by state law.»

Specifically, this overlap occurred because: (1) The NPRM preamble, but not the NPRM regulation text, indicated that agencies conducting both oversight and law enforcement activities would be subject to the oversight requirements when conducting oversight activities; and (2) the NPRM addressed some disclosures for investigations of health care fraud in the law enforcement paragraph (proposed § 164.510 (f)(5)(i)-RRB-, while health care fraud investigations are central to the purpose of health care oversight agencies (covered under proposed § 164.510 (c)-RRB-.

To clarify further that health oversight disclosure rules apply generally in health care fraud investigations (subject to the exception described above), in the final rule, we eliminate proposed § 164.510 (f)(5)(i), which would have established requirements for disclosure related to health care fraud for law enforcement purposes.

Response: This level of detail is necessary to ensure that individuals» rights with respect to their health information are clear, while also ensuring that information necessary for important public functions, such as protecting public health, promoting biomedical research, fighting health care fraud, and notifying family members in disaster situations, will not be impaired by this regulation.

For example, a covered entity could disclose protected health information in the course of reporting suspected health care fraud to a health oversight agency.

Where the individual is not the subject of the activity or investigation, or where the investigation or activity relates to health care fraud, a covered entity may make a disclosure pursuant to § 164.512 (d)(1), allowing uses and disclosures for health oversight activities.

Comment: Many commenters noted that proposed § 164.510 (f)(5)(i), which covered disclosures for investigations and prosecutions of health care fraud, overlapped with proposed § 164.510 (c) which covered disclosures for health oversight activities.

The preamble to the proposed rule listed the following as examples of health oversight agencies that conduct oversight activities relating to the health care system: state insurance commissions, state health professional licensure agencies, Offices of Inspectors General of federal agencies, the Department of Justice, state Medicaid fraud control units, Defense Criminal Investigative Services, the Pension and Welfare Benefit Administration, the HHS Office for Civil Rights, and the FDA.

For the purposes of this rule, we intend for investigations regarding issues (a) through (c) above to mean investigations of health care fraFor the purposes of this rule, we intend for investigations regarding issues (a) through (c) above to mean investigations of health care frafor investigations regarding issues (a) through (c) above to mean investigations of health care fraud.

Auto Insurance auto insurance fraud auto insurance policy auto insurer automobile insurance auto policy Blue Cross and Blue Shield of Michigan (BCBSM) car accidents car insurance catastrophic claims Coalition for Auto Insurance Reform disability benefits disability coverage health care coverage health care plans Health Insurance health insurance policies Industry Segments Insurance and the Michigan Economy Insurance Regulation Insurance «Pools» Jobs Legislators Guide MCCA medicaid medicare MIC Michigan Michigan Catastrophic Claims Association Michigan Catastrophic Claims Association (MCCA) Michigan Insurance Coalition michigan legislature Michigan no - fault National Association of Insurance Commissioners (NAIC) National Conference of Insurance Legislators (NCOIL) No - Fault Automobile Insurance no fault no fault reform Office of Financial and Insurance Regulation Office of Financial and Insurance Regulation (OFIR) OFIR personal injury protection personal injury protection coverage PIP The Verbal Threshold Get Involved (1) In the News (96) Industry Studies (9) Legislation and Testimony (7) Press Roohealth care coverage health care plans Health Insurance health insurance policies Industry Segments Insurance and the Michigan Economy Insurance Regulation Insurance «Pools» Jobs Legislators Guide MCCA medicaid medicare MIC Michigan Michigan Catastrophic Claims Association Michigan Catastrophic Claims Association (MCCA) Michigan Insurance Coalition michigan legislature Michigan no - fault National Association of Insurance Commissioners (NAIC) National Conference of Insurance Legislators (NCOIL) No - Fault Automobile Insurance no fault no fault reform Office of Financial and Insurance Regulation Office of Financial and Insurance Regulation (OFIR) OFIR personal injury protection personal injury protection coverage PIP The Verbal Threshold Get Involved (1) In the News (96) Industry Studies (9) Legislation and Testimony (7) Press Roohealth care plans Health Insurance health insurance policies Industry Segments Insurance and the Michigan Economy Insurance Regulation Insurance «Pools» Jobs Legislators Guide MCCA medicaid medicare MIC Michigan Michigan Catastrophic Claims Association Michigan Catastrophic Claims Association (MCCA) Michigan Insurance Coalition michigan legislature Michigan no - fault National Association of Insurance Commissioners (NAIC) National Conference of Insurance Legislators (NCOIL) No - Fault Automobile Insurance no fault no fault reform Office of Financial and Insurance Regulation Office of Financial and Insurance Regulation (OFIR) OFIR personal injury protection personal injury protection coverage PIP The Verbal Threshold Get Involved (1) In the News (96) Industry Studies (9) Legislation and Testimony (7) Press RooHealth Insurance health insurance policies Industry Segments Insurance and the Michigan Economy Insurance Regulation Insurance «Pools» Jobs Legislators Guide MCCA medicaid medicare MIC Michigan Michigan Catastrophic Claims Association Michigan Catastrophic Claims Association (MCCA) Michigan Insurance Coalition michigan legislature Michigan no - fault National Association of Insurance Commissioners (NAIC) National Conference of Insurance Legislators (NCOIL) No - Fault Automobile Insurance no fault no fault reform Office of Financial and Insurance Regulation Office of Financial and Insurance Regulation (OFIR) OFIR personal injury protection personal injury protection coverage PIP The Verbal Threshold Get Involved (1) In the News (96) Industry Studies (9) Legislation and Testimony (7) Press Roohealth insurance policies Industry Segments Insurance and the Michigan Economy Insurance Regulation Insurance «Pools» Jobs Legislators Guide MCCA medicaid medicare MIC Michigan Michigan Catastrophic Claims Association Michigan Catastrophic Claims Association (MCCA) Michigan Insurance Coalition michigan legislature Michigan no - fault National Association of Insurance Commissioners (NAIC) National Conference of Insurance Legislators (NCOIL) No - Fault Automobile Insurance no fault no fault reform Office of Financial and Insurance Regulation Office of Financial and Insurance Regulation (OFIR) OFIR personal injury protection personal injury protection coverage PIP The Verbal Threshold Get Involved (1) In the News (96) Industry Studies (9) Legislation and Testimony (7) Press Room (56)

The OIG has also created compliance recommendations for the health care industry to follow in order to avoid fraud.

Andy Fontalbert has 20 + years of health care experience: 15 + years of consulting, fraud and abuse projects, provider and member portal projects, Project Management of Private Health Exchange, multiple management positions for Medicaid projects, 20 + years claims experience, 15 + years Project Management, 20 + years Prescription Benefits Management, 20 + years complex policy and procedures within health care, multiple system health care experience: 15 + years of consulting, fraud and abuse projects, provider and member portal projects, Project Management of Private Health Exchange, multiple management positions for Medicaid projects, 20 + years claims experience, 15 + years Project Management, 20 + years Prescription Benefits Management, 20 + years complex policy and procedures within health care, multiple system Health Exchange, multiple management positions for Medicaid projects, 20 + years claims experience, 15 + years Project Management, 20 + years Prescription Benefits Management, 20 + years complex policy and procedures within health care, multiple system health care, multiple system imp...

Department of Justice (Wheeling, WV & Washington, DC) 08/2004 — 05/2007 United States Attorney's Office — Insert Title • Provide a variety of services for the United States Attorney's office focused on trial file preparation and evidence • Screen attorney's filings to ensure the US District Court guidelines are followed in sensitive cases sealed from the public • Provide support on ad - hoc requests from US Attorneys • Assist in analyzing databases, spreadsheets, and records in health care fraud cases • Perform upkeep and maintain the civil and criminal law libraries • Recognized with the Performance Award, Civil Division, United States Attorney's Office, for work excellence