This is why it is essential to have competent qualified workers, from coders to billers, in the healthcare setting. Aside from outright fraud, oftentimes there is simply a lack of knowledge and proper procedures which allow for errors and omissions as well as abuse and fraud. Ultimately, it is the doctor and/or managers who face the consequences so competent qualified workers are the safety net that ensures proper reimbursement as well as administrative procedures are done.
Feds Announce Largest Ever Criminal Medical Fraud Takedown
Attorney General Loretta E. Lynch and the Department of Health and Human Services (HHS) Secretary Sylvia Matthew Burwell announced yesterday the largest ever healthcare fraud takedown.
The government claimed that those involved billed Medicare and Medicaid for medically unnecessary treatments, or treatments never provided. A total of 243 individuals were charged including 46 doctors, nurses and other licensed medical professionals for a total of $712 million in fraudulent billing.
Over 44 of the defendants were charged with fraud related to the Medicare prescription drug benefit program, also known as Part D.
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