The Exploitation and Fraud of Medicare and Health Care

August 5, 2024 Study Puts a $43 Billion Yearly Price Tag on Cancer Screening

August 5, 2024 Study Puts a $43 Billion Yearly Price Tag on Cancer Screening The estimate focused on five cancers for which there is medically recommended screening — breast, cervical, colorectal, lung and prostate — and found that colonoscopies accounted for most of the costs.  The largest driver of screening costs, according to the study, […]

July 8, 2024, Insurers Pocketed $50 Billion From Medicare for Diseases No Doctor Treated

July 8, 2024, Insurers Pocketed $50 Billion From Medicare for Diseases No Doctor Treated Questionable diagnoses of HIV and other maladies triggered extra Medicare Advantage payments; ‘It’s anatomically impossible.’  Gloria Lee was perplexed when the phone calls started coming in from a representative of her Medicare insurer. Could a nurse stop by her Boston home […]

June 28, 2024, National Enforcement Action Results in 78 Individuals Charged for $2.5B in Health Care Fraud

June 28, 2024, National Enforcement Action Results in 78 Individuals Charged for $2.5B in Health Care Fraud The Justice Department, together with federal and state law enforcement partners, announced today a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 78 defendants for their alleged participation in health care fraud and […]

May 30, 2024, You Can Thank Private Equity for That Enormous Doctor’s Bill

May 30, 2024, You Can Thank Private Equity for That Enormous Doctor’s Bill Private-equity investors have poured billions into healthcare but often game the system, hurting both doctors and patients.  When a business gets bigger, it forces mom-and-pop players out of the market, but it can boost profits and bring down costs, too. Think about […]

February 9, 2024, Staggering Rise in Catheter Bills Suggests Medicare Scam

February 9, 2024, Staggering Rise in Catheter Bills Suggests Medicare Scam Seven medical supply companies made suspicious claims involving thousands of Medicare beneficiaries, an advocacy group found.  Linda Hennis was checking her Medicare statement in January when she noticed something strange: It said a company she had never heard of had been paid about $12,000 […]

March 22, 2023 – Biden Plan to Cut Billions in Medicare Fraud Ignites Lobbying Frenzy

March 22, 2023 – Biden Plan to Cut Billions in Medicare Fraud Ignites Lobbying Frenzy The Biden administration has proposed changes to how it would pay private Medicare Advantage plans.  The change in payment formulas is an effort, Biden administration officials say, to tackle widespread abuses and fraud in the increasingly popular private program.  The […]