Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

False Medicaid Claims

DOJ Recovers $2.5B in Healthcare Fraud, False Claims in 2018

January 3, 2019 - 2018 was a bad year to be a healthcare fraudster.  The Department of Justice (DOJ) has announced that $2.5 billion of the total $2.8 billion recovered under the False Claims Act can be attributed to fraud and improper claims from healthcare providers during the fiscal year. This was the ninth consecutive year that civil healthcare fraud settlements and judgments have topped $2...


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Poor Data Quality in CA Medicaid Drives $4B in Improper Payments

by Thomas Beaton

California's Medicaid program, Medi-Cal, made over $4 billion in improper payments to cover benefits for ineligible beneficiaries because of poor data quality and insufficient oversight, according to a new report from state...

Texas Wrongly Claimed $3.8M in Medicaid Reimbursements

by Thomas Beaton

Texas’s Department of Health and Human Services failed to adhere to federal guidelines and inappropriately claimed $3.8 million in Medicaid managed care reimbursement.    The Office of Inspector General (OIG) recently...

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