*  Reducing Fraud and Abuse

The skyrocketing cost of health care-including the cost of fraud and abuse within federal health care systems-is a primary ... Some examples of how the law seeks to reduce fraud and abuse include: *Expansion of the Recovery Audit Contractors (RACs) ... The skyrocketing cost of health care-including the cost of fraud and abuse within federal health care systems-is a primary ...

*  U.S. GAO - Fraud Detection Systems: Centers for Medicare and Medicaid Services Needs to Expand Efforts to Support Program...

Fraud Detection Systems:. Centers for Medicare and Medicaid Services Needs to Expand Efforts to Support Program Integrity ... Additionally, CMS had not taken steps to ensure widespread use of One PI to enhance efforts to detect fraud, waste, and abuse. ... To integrate claims information and improve its ability to detect fraud, waste, and abuse in these programs, CMS initiated two ... and CMS's progress toward achieving its goals and objectives for using these systems to detect fraud, waste, and abuse. ...

*  Prevent fraud. Achieve compliance.

This e-book explores how SAS solutions for fraud detection and prevention provide an essential layer of protection that helps ... A fragmented approach to dealing with fraud and compliance leaves you vulnerable to criminals who can pinpoint and exploit ...

*  Welfare-to-work fraud detection inadequate, say MPs - BBC News

The government failed to be rigorous enough in efforts to detect fraud among its welfare-to-work providers, a committee of MPs ... The government failed to be rigorous enough in detecting fraud among its welfare-to-work providers, a committee of MPs has said ... "We have ... put in place the toughest anti-fraud measures ever included in a government back-to-work scheme," he added. ... Committee chair Margaret Hodge said the DWP had "not been proactive in setting in place systems which root out fraud". ...

*  Long firm fraud - Wikipedia

A long firm fraud (also known as a consumer credit fraud)[1] is a fraud that uses a trading company set up for fraudulent ... "ACPOS Best Practice Guide to Long Firm Fraud". East of Scotland Fraud Forum. Archived from the original on August 19, 2008.. ... Long firm frauds have become significantly less common in recent years since it is no longer possible to operate for any length ... "Long Term and Short Term Fraud". actionfraud. Archived from the original on 2010-02-10. Retrieved 2012-02-14.. ...

*  Marriage fraud promise - CBC Player

Federal Immigration Minister Jason Kenney says he plans to crackdown on immigration marriage fraud, the CBC's Natalie Clancy ... Federal Immigration Minister Jason Kenney says he plans to crackdown on immigration marriage fraud, the CBC's Natalie Clancy ...

*  Market Overview: Fraud Management Solutions

Fraud can impact a company's goodwill. With fraud rings expanding operations beyond the online channel to ATM, POS, branch, and ... Market Overview: Fraud Management Solutions. Seven Tenets Of Effectively Combating Fraud Costs. August 25, 2010 ... integrate disparate fraud management systems' case-management interfaces in order to navigate between fraud cases and cross ... Fraud causes companies to lose money in many ways: They face losses due to chargebacks, unrecoverable transfers, and ...

*  Ripoff Report | the transition companies complaints, reviews, scams, lawsuits and frauds reported, 466,271 results

... the transition companies lawsuits and the transition companies frauds reported. Click here and find all the transition ... Montague Mattress company Jon Zyto Fraud. Bullying. Will not pay you for work done. Calgary Canada Nationwide Author: ... THE TRANSITION COMPANIES Ripoff Reports, Complaints, Reviews, Scams, Lawsuits and Frauds Reported Your Search: the transition ... Ripoff Report , Complaints Reviews Scams Lawsuits Frauds Reported. File your review. Consumers educating consumers.™ ...

*  Insurance Fraud

... from the issuer (seller) includes selling policies from non-existent companies, failing to submit premiums and ... What is 'Insurance Fraud'. An illegal act on the part of either the buyer or seller of an insurance contract. Insurance fraud ... BREAKING DOWN 'Insurance Fraud'. Insurance fraud is basically an attempt to exploit an insurance contract. Insurance is meant ... Buyer fraud includes exaggerated claims, falsified medical history, post-dated policies, viatical fraud, faked death or ...

*  DOB: Protect Yourself from Internet Fraud

The Internet is unique technology with characteristics that offer potential for certain types of fraud. As a result, scam ... Protect Yourself from Internet Fraud Abstract: Protect Yourself Against CyberFraud The Internet has brought an exciting global ... The Federal Bureau of Investigation (FBI) and the National White Collar Crime Center host an Internet Fraud Complaint Center. ... If you see something suspicious on the Internet or if you've been victimized by a fraud, immediately contact the Banking ...

*  CARG: Coronary Artery Rehabilitation Group Blog: Prominent cardiologist admits record $19 million medical billing fraud scheme ...

"After years of prominence in his field, Jose Katz will now be remembered for his record-setting fraud," said U.S. Attorney Paul ... with offices in New York City and New Jersey carried out what federal authorities called the largest health care fraud ever ...

*  Securities Fraud

... CRIME. Presence on this list implies merely that, to the best of our knowledge, charges were filed against ...

*  Cell Phone Fraud | Federal Communications Commission

Call your carrier if you think you have been a victim of subscriber fraud. What is Cell Phone Cloning Fraud? Every cell phone ... What is Subscriber Fraud? Subscriber fraud occurs when someone signs up for service with fraudulently obtained customer ... A primary type of cell fraud is subscriber fraud. The cellular industry estimated that carriers lose more than $150 million per ... Resolving subscriber fraud could develop into a long and difficult process for victims. It may take time to discover that ...

*  Fraud risk assessment methodologies

... our security management expert provides our member with a series of fraud risk assessment methodologies and factors to address ... The following resources also provide steps for carrying out a fraud assessment:. www.community.nsw.gov.au/ documents/fraud_risk ... Keep in mind, a 'yes' does not mean fraud has occurred, but it's a strong indication that it has or will occur. It also helps ... In this Ask the Expert Q&A, our security management expert provides our member with a series of fraud risk assessment factors ...

*  McCartney fraud charge over 'love child' - Telegraph

Sir Paul McCartney is facing fraud charges in Germany after a German woman, who says she is his love child, claimed the former ... McCartney fraud charge over 'love child'. Sir Paul McCartney faces claims that he fathered a child in Hamburg in the early ... Sir Paul McCartney is facing fraud charges in Germany after a German woman, who says she is his love child, claimed the former ... A spokesman for the public prosecutors office confirmed: "There is a complaint of fraud against him [McCartney] that we are ...

*  Fraud Risk Assessment

Fraud professionals can use this tool to assist organizations in identifying fraud risks and developing a fraud risk response. ... s Fraud Risk Assessment is an invaluable resource for fraud examiners to use in identifying and addressing their clients' or ... Fraud Risk Assessment Tool. The ACFE's Fraud Risk Assessment tool is an invaluable resource for fraud examiners to use in ... Fraud professionals can use this tool to assist organizations in identifying fraud risks and developing a fraud risk response. ...

*  MDHHS - Fraud & Abuse

The Program Integrity toll-free hotline and email address to report suspected fraud and abuse by a store or client of your ... Examples of fraud and abuse may include:. Clients who:. *Sell or give away formula or foods purchased with WIC benefits ( ... Fraud may include buy, selling or trading of WIC benefits for cash and non-WIC foods. ... Increase awareness of potential areas of WIC Program fraud/abuse.. *Assume a highly visible and proactive role in preventing ...

*  UN probes allegations of corruption, fraud | Reuters

We can say that we found mismanagement and fraud and corruption to an extent we didn't really expect.' Ahlenius said two-thirds ... Appleton added that many of the allegations of corruption and fraud ultimately turn out to be unsubstantiated. Ahlenius said ... 600 million were confirmed to have involved fraud at some level. The total U.N. peacekeeping budget for 2007-2008 amounts to ... held the news conference in response to media reports suggesting that there has been widespread fraud related to U.N. ...

*  Fraud cases could accelerate - UPI.com

... of prosecuting executives for fraud, a top fraud attorney said. ... Fraud cases uncovered in sour economy *Child care fraud costly ... of prosecuting executives for fraud, a top fraud attorney said. ... Fraud cases could accelerate March 12, 2009 at 9:02 AM Follow @ ... On the other hand, the Times reported, expanded fraud statues could lead to a rising percentage of guilty pleas, as defendants ... With a financial crisis ripping into global economies, Obama wants to "send a message of zero tolerance for mortgage fraud," ...

*  Nigella Lawson on Assistants' 'Mortifying' Fraud Trial - ABC News

Nigella Lawson spoke out about three-week fraud trial involving her two former assistants, which put her personal life in the ... Last month, two of Lawson's former employees were acquitted of fraud after allegations of using company credit cards for ...

*  SEC.gov | Internet Fraud

... www.investor.gov/investing-basics/avoiding-fraud/types-fraud/internet-social-media-fraud ... Offering frauds come in many different forms. Generally speaking, an offering fraud involves a security of some sort that is ... Investor Alert: Social Media and Investing - Avoiding Fraud. Internet Fraud: How to Avoid Internet Investment Scams. http:// ...

*  Miami Physician Pleads Guilty for Role in $20 Million Health Care Fraud Scheme | OPA | Department of Justice

Fraud Section Trial Attorney A. Brendan Stewart is prosecuting the case. Since its inception in March 2007, the Medicare Fraud ... Miami Physician Pleads Guilty for Role in $20 Million Health Care Fraud Scheme. A Miami physician pleaded guilty today for his ... The FBI and HHS-OIG investigated the case, which was brought as part of the Medicare Fraud Strike Force, under the supervision ... To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov. ...

*  State Contracts with IBM for Medicaid Fraud Audit | North Carolina Medical Society

Perdue announced that the State would partner with IBM to audit North Carolina Medicaid to search for dollars lost due to fraud ... State Contracts with IBM for Medicaid Fraud Audit. By Conor Brockett / March 26, 2010 at 2:55 pm. ... Perdue announced that the State would partner with IBM to audit North Carolina Medicaid to search for dollars lost due to fraud ...

*  Ripoff Report | professional collections complaints, reviews, scams, lawsuits and frauds reported, 28,044 results

... professional collections lawsuits and professional collections frauds reported. Click here and find all professional ... PROFESSIONAL COLLECTIONS Ripoff Reports, Complaints, Reviews, Scams, Lawsuits and Frauds Reported Your Search: professional ... Ripoff Report , Complaints Reviews Scams Lawsuits Frauds Reported. File your review. Consumers educating consumers.™ ... Internet Fraud: Mobile Money Code Greg Anderson Andrew Carpetti Seattle, Washington ...

*  Medicaid+fraud Articles, Photos and Videos - AOL

Browse our collection of medicaid fraud information for news stories, slideshows, opinion pieces and related videos posted on ...

Pious fraud: Pious fraud (Latin: pia fraus) is used to describe fraud in religion or medicine. A pious fraud can be counterfeiting a miracle or falsely attributing a sacred text to a biblical figure due to the belief that the "end justifies the means", in this case the end of increasing faith by whatever means available.Scientific misconduct: Scientific misconduct is the violation of the standard codes of scholarly conduct and ethical behavior in professional scientific research. A Lancet review on Handling of Scientific Misconduct in Scandinavian countries provides the following sample definitions: (reproduced in The COPE report 1999.Quackery: Quackery is the promotion of fraudulent or ignorant medical practices. A "quack" is a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, or qualifications he or she does not possess; a charlatan".Howard Phillips (politician)Razvilka, Moscow Oblast: Razvilka () is a rural locality (a settlement) in Leninsky District of Moscow Oblast, Russia, located in the "green forests and parks space" surrounding the city of Moscow, on the Kashira Highway. Population: Postal code: 142717.Labor Standards Bureau: The is a bureau of the Ministry of Health, labour and Welfare responsible for maintaining work standards in Japan. It is tasked with securing and improving working conditions, ensuring the safety and health of workers, and is also responsible for managing Workers' Accident Compensation Insurance.A Tomb for Boris Davidovich: A Tomb for Boris Davidovich (Serbo-Croatian: Grobnica za Borisa Davidoviča / Гробница за Бориса Давидовича) is a collection of seven short stories by Danilo Kiš written in 1976 (translated into English by Duska Mikic-Mitchell in 1978). The stories are based on historical events and deal with themes of political deception, betrayal, and murder in Eastern Europe during the first half of the 20th century (except for "Dogs and Books" which takes place in 14th century France).Outstanding claims reserves: Outstanding claims reserves in general insurance are a type of technical reserve or accounting provision in the financial statements of an insurer. They seek to quantify the outstanding loss liabilities for insurance claims which have been reported and not yet settled

(1/124) Health care programs: fraud and abuse; revised OIG civil money penalties resulting from public law 104-191. Office of Inspector General (OIG), HHS. Final rule.

This final rule revises the OIG's civil money penalty (CMP) authorities, in conjunction with new and revised provisions set forth in the Health Insurance Portability and Accountability Act of 1996. Among other provisions, this final rulemaking codifies new CMPs for excluded individuals retaining ownership or control interest in an entity; upcoding and claims for medically unnecessary services; offering inducements to beneficiaries; and false certification of eligibility for home health services. This rule also codifies a number of technical corrections to the regulations governing OIG's sanction authorities.  (+info)

(2/124) Privacy Act; implementation. Office of Inspector General (OIG), HHS. Final rule.

This final rule exempts the new system of records, the Healthcare Integrity and Protection Data Bank (HIPDB), from certain provisions of the Privacy Act (5 U.S.C. 552a). The establishment of the HIPDB is required by section 1128E of the Social Security Act (the Act), as added by section 221(a) of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Section 1128E of the Act directed the Secretary to establish a national health care fraud and abuse data collection program for the reporting and disclosing of certain final adverse actions taken against health care providers, suppliers or practitioners, and to maintain a data base of final adverse actions taken against health care providers, suppliers and practitioners. Regulations implementing the new HIPDB were published in the Federal Register on October 26, 1999 (64 FR 57740). The exemption being set forth in this rule applies to investigative materials compiled for law enforcement purposes.  (+info)

(3/124) Unconventional dentistry: Part III. Legal and regulatory issues.

This is the third in a series of 5 articles providing a contemporary overview and introduction to unconventional dentistry (UD) and its correlation to unconventional medicine (UM). UD presents issues of dental quackery, fraud and malpractice, and it also engenders professional concerns about public protection and professional risks. Case reports illustrate numerous issues. The reader is encouraged to evaluate the cases for problems related to malpractice, fraud, ethics, behaviours and professionalism. A discussion of ethical issues is beyond the scope of this paper.  (+info)

(4/124) An on-site audit of the South African trial of high-dose chemotherapy for metastatic breast cancer and associated publications.

PURPOSE: The randomized study reported by Bezwoda et al of high-dose chemotherapy (HDC) for treatment of metastatic breast cancer was audited on site to verify the study results. Additional published studies were reviewed to determine whether they had been subject to the required institutional oversight. PATIENTS AND METHODS: Ninety patients were reported to have been randomized and treated on this trial. A log of the names, hospital numbers, entry dates, and regimen received had been provided by the principal investigator. A search of more than 15,000 sets of medical records available from two Johannesburg hospitals was performed to locate records for as many of these 90 patients as possible. Standard auditing techniques were used. Additional clinical trials published by Bezwoda were compared against the minutes of the University of the Witwatersrand Committee for Research on Human Subjects to verify review and approval. RESULTS: Records for only 61 of the 90 patients could be found. Of these 61, only 27 had sufficient records to verify eligibility for the trial by the published criteria. Of these 27, 18 did not meet one or more eligibility criteria. Only 25 patients appeared to have received their assigned therapy temporally associated with their enrollment date, and all but three of these 25 received HDC. The treatment details of individual patients were at great variance from the published data. Nine other trials reported by Bezwoda were not reviewed or approved by the appropriate institutional committee despite statements to the contrary in the publications. CONCLUSION: The multiple publications of this study do not report verifiable data, and nine other publications coauthored by the principal investigator contain at least one major untrue statement.  (+info)

(5/124) Fraud-and-abuse enforcement in Medicare: finding middle ground.

Medicare fraud and abuse cost billions of dollars each year. Yet Congress is considering legislation to hamper enforcement. Providers' anger over enforcement led to a congressional compromise several years ago to limit excesses. If providers and their advocates were to hobble enforcement, this could provoke a backlash. Instead, the existing compromise should be strengthened to accommodate legitimate provider concerns while allowing enforcement against major fraud and abuse. Government should further confine, structure, and check its discretion in applying the False Claims Act. Enhancing the Health Care Financing Administration's capacity to ensure that contractors pay claims properly would remove additional points of friction.  (+info)

(6/124) Consumers versus managed care: the new class actions.

The plaintiffs in pending consumer class-action lawsuits against health maintenance organizations (HMOs) should fail in their claims for damages for fraud under federal anti-racketeering legislation. Although HMOs have regularly failed to disclose their business methods and have not strictly honored their contractual coverage promises, the circumstances in which they introduced cost controls into a market sadly lacking them suggest motives not deserving punitive sanctions. Courts could easily find that HMOs violated the Employee Retirement Income Security Act (ERISA), however. Injunctive relief compelling more extensive disclosures and clearer contracts might well legitimize HMOs' methods and generally improve the performance of the health care marketplace.  (+info)

(7/124) Medicare program; civil money penalties, assessments, and revised sanction authorities. Final rule with comment period.

This final rule with comment period is a technical rule that updates our civil money penalty (CMP) regulations to add CMP authorities already enacted as part of the Balanced Budget Act of 1997 (BBA) and delegated to us. The rule delineates our authority to assess penalties for: failure to bill outpatient therapy services or comprehensive outpatient rehabilitation services (CORS) on an assignment-related basis, failure to bill ambulance services on an assignment-related basis, failure to provide an itemized statement for Medicare items and services to a Medicare beneficiary upon his/her request, and failure of physicians or nonphysician practitioners to provide diagnostic codes for items or services they furnish or failure to provide this information to the entity furnishing the item or service ordered by the practitioner. The rule also contains technical changes to further conform our current CMP rules to changes in the statute enacted by the BBA.  (+info)

(8/124) Providing long-term care benefits in cash: moving to a disability model.

This paper examines the role of a disability approach to the allocation of long-term care benefits. It first highlights the important elements of long-term care that support a disability model. It then reviews the advantages and disadvantages of this approach relative to the traditional indemnity model and summarizes key features of selected domestic and international programs that offer a disability-type benefit. The paper identifies and elaborates on the major implementation challenges and concludes with a recommendation for further examination of the costs and benefits of this approach to the public coffers, the private market, and long-term care consumers.  (+info)



time

  • It may take time to discover that subscriber fraud has occurred and even more time to prove that you did not incur the debts. (fcc.gov)