Who owns Middle Georgia Family rehab?
Brenda HicksBrenda Hicks, owner of Middle Georgia Family Rehab LLC, 100 Hamilton Pointe Drive, Byron and 5021 Mercer University Drive, 478-956-4916.
What is the Medicare false claim program?
False Claims Act [31 U.S.C. The civil FCA protects the Government from being overcharged or sold shoddy goods or services. It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.
What is a major part of Medicare fraud?
Misusing codes on a claim, such as upcoding or unbundling codes. Upcoding is when a provider assigns an inaccurate billing code to a medical procedure or treatment to increase reimbursement. Medicare abuse can also expose providers to criminal and civil liability.
How does Medicare detect fraud?
Detect fraud by examining both the Medicare Summary Notice (MSN) you receive from Medicare after your claims are paid, and/or the Explanation of Benefits (EOB) you receive from your Part C and/or Part D plan. (You can also view your MSNs online by accessing your Medicare account at Medicare.gov.)
What is a disadvantage of the False Claims Act?
The False Claims Act Helps Keep Patients Safe But other frauds, such as providing medically unnecessary services or dosage fraud, have the potential to wreak havoc on the health of Medicare and Medicaid beneficiaries. An especially horrific example of fraud that had negative consequences for patients is that of Dr.
Should I give my Medicare number over the phone?
Don't share your Medicare or Social Security number (or other personal information) with anyone who contacts you out of the blue by phone, text or email or shows up unannounced at your door. Don't send or give your old Medicare card to anyone. Impostors may claim you need to return it.
What are the civil penalties if a person is found guilty of Medicare fraud?
Furthermore, individuals who have been convicted of Medicare fraud may be ordered to pay fines worth up to $250,000. Professionals who are accused of any of these violations may also face substantial civil fines. The fine for each false claim is $11,000, while the fine for every kickback is $50,000.
Which governmental agency is responsible for monitoring Medicare fraud?
The Department of Health and Human Services Office of Inspector General (HHS-OIG) focuses primarily on fraud on the Medicare and Medicaid programs and the health benefits programs of the United States Public Health Service (PHS) such as the Indian Health Service.
Who commits health care fraud?
Health care fraud can be committed by medical providers, patients, and others who intentionally deceive the health care system to receive unlawful benefits or payments. The FBI is the primary agency for investigating health care fraud, for both federal and private insurance programs.
How much did the Medical Center of Central Georgia pay?
The Medical Center of Central Georgia (MCCG) has agreed to pay $20 million to settle allegations that the hospital violated the False Claims Act by billing Medicare for more expensive inpatient services that should have been billed as less costly outpatient or observation services, the Justice Department announced today.
How did MCCG violate the False Claims Act?
The government contends that from 2004 through 2008, MCCG violated the False Claims Act by knowingly charging Medicare for medically unnecessary inpatient admissions when the care provided should have been billed as less costly outpatient or observation services.
When was the HEAT settlement announced?
This settlement illustrates the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by the Attorney General and the Secretary of Health and Human Services.
How much money has the False Claims Act recovered?
One of the most powerful tools in this effort is the False Claims Act. Since January 2009, the Justice Department has recovered a total of more than $24 billion through False Claims Act cases, with more than $15.3 billion of that amount recovered in cases involving fraud against federal health care programs.
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The Justice Department says it has executed "an unprecedented nationwide sweep" of 36 federal districts.
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In addition, CMS is suspending payment to a number of providers using its suspension authority provided in the ACA.
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How many doctors were arrested for Medicare fraud?
Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced today an unprecedented nationwide sweep led by the Medicare Fraud Strike Force in 36 federal districts, resulting in criminal and civil charges against 301 individuals, including 61 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $900 million in false billings. Twenty-three state Medicaid Fraud Control Units also participated in today’s arrests. In addition, the HHS Centers for Medicare & Medicaid Services (CMS) is suspending payment to a number of providers using its suspension authority provided in the Affordable Care Act. This coordinated takedown is the largest in history, both in terms of the number of defendants charged and loss amount.
How much did Home Health Companies charge Medicare?
Home health companies submitted approximately $23.3 million in billings to Medicare based on the physician’s fraudulent certifications. In the Central District of California, 22 defendants were charged for their roles in schemes to defraud Medicare of approximately $162 million.
Why did Medicare pay kickbacks?
In many cases, patient recruiters, Medicare beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could then submit fraudulent bills to Medicare for services that were medically unnecessary or never performed.
What is Medicare Strike Force?
The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.
How many defendants were charged in the Medicaid fraud case?
In the Districts of Maine, Alaska, Kansas, Connecticut and Vermont, five defendants were charged for their roles in Medicaid-related schemes. In the Eastern District of Missouri, four defendants, including a doctor and pharmacist, were charged for their roles in schemes involving over $3 million in billings.
How much did Medicare pay for home health referrals?
Numerous companies that submitted claims to Medicare using the fraudulent home health referrals from the physician were paid over $38 million by Medicare. In the Northern District of Texas, 11 people were charged in cases involving over $47 million in alleged fraud.
How much money has the Justice Department recovered from false claims?
Since January 2009, the Justice Department’s Civil Division, along with U.S. Attorney’s Offices around the country, has recovered a total of more than $29.9 billion through False Claims Act cases, with more than $18.3 billion of that amount recovered in cases involving fraud against federal health care programs.
How many people have been arrested for Medicare fraud?
(Reuters) -- The U.S. Department of Justice said on Thursday that 243 people have been arrested across the country, charged with submitting fake billing for Medicare, a government healthcare program, that totaled $712 million.
How many doctors were arrested in the US?
Those arrested included 46 doctors, nurses and other licensed medical professionals. The charges are based on a variety of alleged fraud schemes, the government said, including submitting claims to Medicare and Medicaid, the healthcare program for low-income individuals, for treatments that were medically unnecessary and often never provided.
How many defendants were charged in the Miami case?
In Miami, 73 defendants were charged with offenses involving approximately $263 million in false billings. Other cities involved include Houston, Dallas and McAllen, Texas; Los Angeles; Detroit; Tampa; Brooklyn, New York; and New Orleans. "In the days ahead, the Department of Justice will continue our focus on preventing wrongdoing ...