The National Healthcare Anti-Fraud Association approximates 3 to 10 percent of annual healthcare expenditures account to fraudulent claims. This means that in the $600 billion spent for Medicare back in 2012, $60...

How did healthcare compliance fare in 2015? Overall, it was quite a busy year for the OIG and various organizations, with noteworthy settlements and enforcement activities beginning as early as January. The OIG excluded ...

  Why does medical care cost so much, anyway? Dumb question.  It doesn’t take a rocket scientist to understand that healthcare costs.  Treatments cost, prescriptions cost, equipment costs.  Everybody knows th...

The True Costs of Transitioning to ICD-10 When it comes to streamlining, medicine often gets a bad rap. There’s lots of paperwork, referrals, appointments, and questionnaires to fill out—and that’s often before pat...

Robert DeConti, assistant inspector general for legal affairs at OIG, and Lisa Re, chief of the OIG Administrative and Civil Remedies Branch, explain why some get excluded...and others don't. OIG enforcement actions are ...

  The cases presented below prove that fraud hurts real people every single time it happens. Outstanding medical bills have become a chief reason for filing personal bankruptcy in the US. The health of patients con...

Why Not to Invest in Exclusion Screening Software Plenty of healthcare organizations don't use exclusion screening software. Wondering why not?  Here's what they'll tell you! It's no big deal to do exclusion ch...

Global warming and the Artic freeze are not our forte, but we've granted ourselves the liberty of forecasting what our 'weathermen' see coming up on the horizon: The Great Exclusion Snowball. Over two months ago, we ...

The dentistry was rotten; the teeth were not. If there was ever a practice worthy of exclusion, Small Smiles Dentistry for Children was it.  To quote just one of the many reports released about the now-infamous chain: ...