Monthly Spotlight on Fraud, Waste, and Abuse - August 2023

Why This Topic Matters

The article highlights enforcement activity that can affect compliance programs, billing practices, privacy safeguards, and organizational risk management. It helps readers recognize the types of conduct that trigger federal investigation, civil settlement, or criminal prosecution.

Article Sections

1. A Former Louisiana Hospice Care Owner Convicted of Defrauding Medicare

   Summarizes a federal criminal case involving hospice-related fraud allegations and Medicare program abuse. The section focuses on enforcement outcomes and the broader compliance issues raised by hospice eligibility and billing oversight.

2. A South Florida Man Sentenced with Prison Time After Buying and Selling 2.6 Million Medicare Beneficiary Identification Numbers

   Describes a prosecution involving the unlawful trafficking of Medicare beneficiary information and related federal charges. The section also references the statutory framework used in the case and the types of personal data involved.

3. An Adult and Pediatrics Healthcare Practice Has Agreed to Pay $3 Million to Settle FCA Allegations

   Reviews civil allegations involving Medicaid billing practices and a settlement under the False Claims Act. The section addresses alleged overbilling, related services, and whistleblower-driven enforcement.