US Elections
fromwww.nytimes.com
3 weeks agoTrump Vowed to Crack Down on Fraudsters, but He's Pardoned Dozens
Salomon Melgen defrauded Medicare of $42 million and was later granted clemency by President Trump after serving time for his crimes.
#medicare-fraud
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US politics
fromwww.mediaite.com
1 month agoTrump Administration Withholds $260 Million In Medicaid Funds for Minnesotans
The Trump administration is withholding $259.5 million in federal Medicaid funding from Minnesota and implementing a six-month national moratorium on Medicare enrollment for medical equipment suppliers to combat alleged fraud.
fromwww.amny.com
1 month agoPHARMACY FRAUD: Two Queens men charged in $120 million adult day care and pharmacy scheme
A pair of scammers from Queens is facing federal charges for allegedly defrauding public health programs of a combined $120 million, the U.S. Department of Justice (DOJ) reported on Monday. Inwoo Kim, also known as Tony Kim and Long Jin, 42, and Daniel Lee, also known as Daniel Yang, 56, both of Flushing, are alleged to have run an adult day care and pharmacy empire starting in 2016 based on scamming taxpayer-funded Medicaid and Medicare, to rake in an illegally obtained $120 million.
Law
US politics
fromLos Angeles Times
2 months agoDr. Oz accused L.A. Armenians of fraud in a viral video. Newsom files civil rights complaint
California Governor Gavin Newsom filed a civil rights complaint against CMS administrator Dr. Mehmet Oz for alleging Armenian crime groups ran widespread Medicare fraud in Los Angeles.
fromwww.mercurynews.com
2 months agoKaiser affiliates will pay $556M to settle a lawsuit alleging Medicare fraud
SAN FRANCISCO Kaiser Permanente affiliates will pay $556 million to settle a lawsuit that alleged the health care giant committed Medicare fraud and pressured doctors to list incorrect diagnoses on medical records to receive higher reimbursements, federal prosecutors said. The deal announced Wednesday came more than four years after the U.S. Department of Justice filed the legal claim in San Francisco that consolidated allegations made in six whistleblower complaints.
Healthcare
fromNextgov.com
7 months agoCMS launches 'chili cook-off competition' to source AI that can detect fraud
CMS announced the start of the "Crushing Fraud Chili Cook-Off Competition" on Aug. 19, calling it "a market-based research challenge" to identify emerging technologies that can "detect anomalies and trends in Medicare Fee-for-Service (FFS) claims data that can be translated into novel indicators of fraud." The agency said it is "prioritizing the use of innovative, data-driven approaches, including explainable AI/ML" that can analyze large datasets to "uncover unusual patterns, anomalies, or trends that may signal fraudulent activity."
Healthcare
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