Medicare is a federal health insurance program that covers eligible individuals who are over 65 years old, disabled, or have end-stage health complications. State or
As healthcare costs continue to rise, government programs such as Medicare and Medicaid, as well as private insurers, rely heavily on managed care organizations (MCOs)
Fraud within Long-Term Care and Assisted Living Facilities is a serious issue. It’s important to be aware of the various forms of fraud that can
It’s easy to see how healthcare fraud can cost taxpayers and governments billions of dollars every year. And while that is not something to be
According to the National Library of Medicine, managed care refers to a healthcare insurance approach that integrates the financing of care and related services to
Medical Loss Ratio (MLR) fraud occurs when plans knowingly misrepresent a proportion of funds spent on patient care and quality improvement measures as opposed to
Medicare Advantage is a type of health insurance plan offered by private companies contracted by the government. Also known as Medicare Part C, Medicare Advantage
The healthcare industry is one that thrives on trust and ethics. When that trust is compromised by fraudulent activities, it’s essential to take a stand.
In this blog, we will explore the journey of whistleblowers, those who discover and report healthcare fraud, and how they are the catalysts that set
Whistleblowers play a crucial role in exposing unethical practices, fraud, and other wrongdoings in various sectors. Recognizing their importance, many jurisdictions offer financial rewards to
The healthcare industry has witnessed a growing collaboration between pharma companies and genetic testing firms in what is known as sponsored testing programs. Under the
Medical fraud is a pervasive issue that undermines the integrity of the healthcare system, affecting patients, providers, and taxpayers alike. As healthcare costs continue to
Medical billing fraud is a rampant problem that affects all areas of the healthcare industry. Unfortunately, rehabilitation (rehab) therapy fraud is on the rise, posing
Medical doctors should be able to focus on providing the best possible care for their patients. However, in the complex world of healthcare, it’s not
In the ever-evolving landscape of healthcare, advancements in technology continue to shape the industry. One area that has garnered attention is artificial intelligence (AI) and
In a world where accountability and transparency are paramount, whistleblowing serves as a powerful tool to combat fraud. Whistleblowers play a crucial role in exposing
