On November 29, during the International Conference on the Foreign Corrupt Practices Act, Deputy Attorney General Rod Rosenstein delivered a speech announcing changes to the Department of Justice (DOJ) 2015 policy memorandum titled “Individual Accountability for Corporate Wrongdoing.” This policy issued by then-Deputy Attorney General Sally Yates, commonly known as the Yates Memo, focuses on
The Department of Justice (DOJ), with assistance from the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) and several other law enforcement agencies, recently announced the results of its national health care fraud takedown. As the government continues to prioritize its efforts on combating health care fraud, it is prudent for
Fraud and abuse. Two words that are thrown around in the Medicare arena quite regularly. But what are fraud and abuse? "Medicare fraud includes: knowingly submitting, or causing to be submitted, false claims or making representations of fact to obtain a Federal health care payment for which no entitlement would otherwise exists; knowingly soliciting, receiving,
The False Claims Act and healthcare fraud and abuse are important areas of focus and enforcement for the government. Refresh your knowledge with the fast facts in our latest infographic.
July 2017 marked the largest healthcare fraud takedown in history. We're bringing you more details about the takedown and important information about the hotline that helped make it happen.
Last year, the Department of Justice (DOJ) released a policy memorandum, titled “Individual Accountability for Corporate Wrongdoing,” also known as the “Yates Memo." The DOJ shifted its approach to fighting corporate fraud and misconduct by focusing its investigative efforts on those individuals within a corporation who perpetrated wrongdoing. The policy guidelines were discussed in this
August 2016 was an important month, with penalties increasing for violations of the False Claims Act and OSHA. Review our infographic to familiarize yourself with the changes. As of August 1st, 2016, there are new penalties for the False Claims Act. The Department of Justice will nearly double the statutory penalties under the False Claims
In light of the historic health care fraud takedown announced by the DOJ and OIG on June 22nd, we've put together an infographic highlighting the important facts.
Medicare Advantage (MA) plans may be doing just what the name says- taking advantage of Medicare. It is highly unlikely that this was the intention in 2003 when MA plans were created by nongovernment entities using a capitated managed care reimbursement approach. The amount of Medicare reimbursement to the MA plan is fixed and calculated
Protecting the integrity of the Medicare program is a top priority. Fortunately, the Affordable Care Act has allotted significant funding for task forces to root out fraud, waste and abuse. Up until now, the task forces have focused recovery efforts on funds already paid to the providers and suppliers. The new focus is on prevention