fraud, waste, and abuse

What’s old is new again: 3 healthcare fraud trends to watch for in 2022

As the health system bent under the weight of the COVID-19 pandemic, bad actors used this opportunity to devise schemes to extract money from the system through fraud, waste, and abuse (FWA)—and despite the pandemic’s unprecedented nature, their schemes largely utilized the same tactics as previous years. Based on our experience, we’ve outlined three common …

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Preparing your payment integrity programs for 2022 and beyond

The COVID-19 pandemic continues to place great burdens on our healthcare system. As providers responded to the added challenges, a few bad actors predictably took advantage of the outbreak to increase their reimbursement by upcoding, unbundling, performing unnecessary services, and billing for services not rendered. While fraudsters used many of the same schemes from before …

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Busted: The top healthcare fraud schemes of Q3 2021

Nefarious actions to defraud public and private healthcare payers continued in the third quarter of 2021, comprising drug testing schemes, kickbacks, money laundering, and more. With help from the National Health Care Anti-Fraud Association (NHCAA), we gathered the most outrageous cases of alleged fraud, waste, and abuse (FWA) from July through September 2021.

Busted: The top fraud schemes of Q2 2021

From fraudulent COVID-19 tests to fake requests for durable medical equipment (DME), this spring was full of attempts to defraud healthcare payers. Here, we’ve gathered some of the most egregious cases of alleged fraud, waste, and abuse (FWA) from April through June 2021 with help from the National Health Care Anti-Fraud Association (NHCAA). 

Busted: The top healthcare fraud schemes of Q1 2021

While 2021 has brought renewed optimism over the COVID-19 pandemic, it has also delivered numerous new fraud, waste, and abuse (FWA) cases in healthcare. From billing inaccurate procedures learned via YouTube to defrauding a fund intended to help those with traumatic brain injuries, bad actors continue to find new ways to increase their reimbursement at the expense of patients and payers alike. Read through some of the top stories …

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