Monthly Spotlight on Fraud, Waste, and Abuse

Why This Topic Matters

Enforcement updates like this help healthcare organizations understand common compliance risk areas and the types of billing practices that attract scrutiny from government investigators and payers.

Article Sections

1. Testing Laboratory Co-Owner Sentenced for $3.8 Million in Fraudulent Billing

   Discusses a federal fraud case involving laboratory operations, alleged misrepresentations, and billing issues affecting multiple payers. The section also references laboratory accreditation and program integrity concerns.

2. Attorney General Charging Medicaid Biller for $1.2 Million in False Liquid Nutrition Claims

   Summarizes a Colorado Medicaid fraud allegation involving durable medical equipment billing and false claims tied to nutritional products. It also notes the role of state investigators and criminal charges.

3. U.S. Attorney Announcing $600,000 False Claims Act Settlement With Medical Practice and Its Owners for Improper Medicare and Medicaid Billing

   Covers a civil settlement involving a medical practice, its owners, and allegations of improper Medicare and Medicaid billing. The section includes discussion of provider enrollment, supervision, and record accuracy concerns.

4. Provider to Pay $600,000 to Resolve False Claims Act Liability Arising From Billing of Electro-Acupuncture Device

   Reviews a settlement involving billing for an electro-acupuncture device and related Medicare oversight. The section also mentions contractor review, claims suspension, and federal agency involvement.