Monthly Spotlight on Fraud, Waste, and Abuse

Why This Topic Matters

These enforcement updates help compliance and revenue cycle professionals stay aware of current risk areas that can affect billing integrity, documentation, referrals, and participation in government healthcare programs.

Article Sections

1. Overview

   An introduction to the monthly fraud, waste, and abuse theme and the general compliance focus of the cases that follow.

2. Owner of Indian Marketing Company Admits Role in $11.5 Million Healthcare Fraud and Kickback Scheme

   A case summary involving alleged kickback activity, marketing practices, and claims submitted to a federal program.

3. Georgia Doctor Pays $225,000 to Resolve Allegations for Improper Billing

   A settlement involving allegations of improper billing practices and a related whistleblower action.

4. Second Owner of California Sleep Clinic Pleads Guilty to Submitting Over $1.5 Million in Fraudulent Claims to Medicare and Medi-Cal for Sleep Studies

   A criminal case summary involving sleep-study claims, referrals, and alleged false submissions to public programs.

5. Attorney General Announces Guilty Verdict of Physician Who Subjected Patients to Unnecessary and Invasive Tests

   A state enforcement case involving alleged kickbacks, unnecessary testing, and claims submitted for radiological services.