Medicare Compliance & Reimbursement - 2011 Issue 37
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Article Overview
This article summarizes recent Department of Justice enforcement actions involving alleged fraud by health care providers in different settings, including home health and durable medical equipment. It is relevant to compliance teams, coders, auditors, and revenue cycle professionals who track fraud enforcement trends and Medicare program integrity issues. The piece discusses the general nature of the schemes, the organizations involved, and the sentencing outcomes without providing technical coding guidance.
Why This Topic Matters
It helps readers understand current fraud enforcement activity affecting Medicare-participating providers and the compliance risks tied to improper claims, kickbacks, and billing practices.
What You Will Learn
- Recent themes in federal health care fraud enforcement
- The types of provider conduct described in DOJ fraud cases
- How enforcement actions relate to Medicare billing integrity and compliance oversight
- Which provider settings were involved in the reported cases
Who Should Read This
- Compliance officers
- Medical coders
- Billing staff
- Auditors
- Revenue cycle professionals
- Health care administrators
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