Firm Partner and Law Clerk Publish Medicare and Medicaid Fraud Survey
A four-part series of articles penned by FHWN partner David L. Haron and law clerk Mercedes Varasteh have been published by the Michigan Chapter of the International Association of Special Investigation Units (IASIU). The articles, which survey Medicare and Medicaid fraud by health care practitioners, have appeared in the August, October, and December 2006 issues of The Investigator, a bi-monthly newsletter published by the Michigan IASIU. The Michigan Chapter of IASIU is dedicated to combating fraud in the insurance industry, and provides members with tips for investigative practices and high standards of conduct.
The first article, entitled “Recognizing Health Care Fraud and What to Do About It,” provides a broad overview of the scope of the Federal False Claims Act as it relates to Medicare and Medicaid fraud. The second, titled “Why Nursing Home Fraud Is Your Problem and How to Fight Back,” addresses the tragic problem of neglect and mistreatment of elderly patients in nursing home and assisted living facilities. Many of these facilities are reimbursed through Medicare funds, and the federal Government is defrauded when Medicare recipients receive substandard treatment or are even abused and neglected.
The third article, “When Courtesy Turns Into Fraud: Routine Waiver of Co-Pays and Deductibles Can Spell Trouble,” outlines how the federal Government is bilked out of billions of dollars by medical professionals who waive Medicare co-payments and deductibles, thereby increasing the amount Medicare and Medicaid must pay.
The fourth article, “Keeping an Eye Out for Fraud? Two Schemes that Deserve Your Attention”, will run in the February 2007 edition and overviews fraudulent schemes such as billing Medicare and/or Medicaid for equipment that was never used, or “double billing” that occurs when a physician bills both a patient/private insurer and a federal health program for services provided.
The first article, entitled “Recognizing Health Care Fraud and What to Do About It,” provides a broad overview of the scope of the Federal False Claims Act as it relates to Medicare and Medicaid fraud. The second, titled “Why Nursing Home Fraud Is Your Problem and How to Fight Back,” addresses the tragic problem of neglect and mistreatment of elderly patients in nursing home and assisted living facilities. Many of these facilities are reimbursed through Medicare funds, and the federal Government is defrauded when Medicare recipients receive substandard treatment or are even abused and neglected.
The third article, “When Courtesy Turns Into Fraud: Routine Waiver of Co-Pays and Deductibles Can Spell Trouble,” outlines how the federal Government is bilked out of billions of dollars by medical professionals who waive Medicare co-payments and deductibles, thereby increasing the amount Medicare and Medicaid must pay.
The fourth article, “Keeping an Eye Out for Fraud? Two Schemes that Deserve Your Attention”, will run in the February 2007 edition and overviews fraudulent schemes such as billing Medicare and/or Medicaid for equipment that was never used, or “double billing” that occurs when a physician bills both a patient/private insurer and a federal health program for services provided.