Healthcare providers want to give their Medicaid patients the best care possible. Providing that care requires listening, observing, diagnosing, recommending, and prescribing. Each step comes with a list of other responsibilities, such as ordering tests, making referrals, reporting every detail of the patient’s care, and filing all information with Medicaid for reimbursement.
Most providers take...
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Category: Health Care Fraud Blog
At Griffin Durham Tanner & Clarkson, we are passionate about providing updates and keeping our community informed on news and law regulations related to healthcare fraud in Savannah and Atlanta.
How do fraud and abuse impact the costs of health care?
Healthcare fraud and abuse result in billions of dollars of losses each year for the federal government and private insurance companies. The ultimate cost of those losses is far-reaching, which is why the government is very committed to detecting and prosecuting healthcare fraud.
Healthcare fraud is a crime under federal law, and those who violate...
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How healthcare scams have become a $100B issue in the U.S.
Healthcare fraud schemes have cost the U.S. government, taxpayers, and insurance companies nearly $100 billion annually. If you think the government isn’t taking any alleged fraud seriously, – or anything that even resembles fraud – think again.
According to the National Health Care Anti-Fraud Association, Medicare and Medicaid fraud...
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Doctors’ Safe Harbors Under the Anti-Kickback Statute
Some people make considerable sacrifices to become a doctor – sacrifices in time, money, and effort are all jeopardized when they’re accused of anti-kickback violations. If you are under investigation or accused of violating the federal Anti-Kickback Statute, it’s in your best interest to work with a healthcare fraud...
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What Are Upcoding and Unbundling?
Health care fraud occurs when a medical provider intentionally submits false or misleading information for use in determining the amount of health care benefits payable. Upcoding and unbundling are forms of health care fraud. At times, innocent health care providers can be routinely accused of upcoding, unbundling, and other forms of health...
Penalties of Health Care Fraud
Penalties for health care fraud violations can range in type and severity. Over the last several years, the federal government has been aggressively cracking down on health care fraud. Health care fraud is a type of crime that involves the filing of dishonest health care claims. Anyone who is convicted of health...
Common Types of Health Care Fraud
Health care fraud can take many forms, but there are common types of health care fraud schemes frequently prosecuted by the Department of Justice (“DOJ”). It is also a frequent subject of False Claims Act (“FCA”) qui tam suits. FCA actions have resulted in the recovery of billions of dollars on...
Choosing a Health Care Fraud Defense Attorney
If you are a health care provider who has been accused of fraud, you need to hire an attorney—and quick. However, not just any attorney will do. You must find a health care fraud defense attorney who will give you the best shot at a successful outcome in your case. Picking the...
Is There is A Government Investigation?
A frequent question we receive from clients is: how do I know whether I am under government investigation? The short answer is: you may not know whether you are under investigation and, if you do know you are under investigation, the government may already be a couple steps ahead.
Who Leads Health Care Prosecutions?
Health care fraud prosecutions are led by three groups of prosecutors.
Most investigations will be handled by a local U.S. Attorney’s office. In U.S. Attorney’s offices across the country, each district has a designated health care fraud coordinator to handle criminal and civil investigations. Although they are based out...