In the ongoing effort to protect the Medicare program, deterrence stands out as a powerful and cost-effective strategy. While detection and enforcement remain critical, deterrence shifts the focus from reacting to fraud af...
Suspect Payments in Medicare Advantage: Why Transparency Matters
Understanding the context of “Suspect Payments”
In Medicare Advantage, payment practices work best when they are clear, consistent, and aligned wi...
Medicare’s $60 Billion Challenge
Medicare loses an estimated $60 billion annually to fraud, waste, and abuse (FWA), a serious drain on critical health resources that directly affects the care and well-being of millions of beneficiaries. These losses not o...
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Combating Fraud with Data Analytics: The Fight for Healthcare Fraud Continues
News on an addiction treatment facility operator caught paying $2.9M in k...
“Outsized Returns” in Combating Healthcare Fraud!
Last week, the U.S. Department of Justice presented several cases highlighting how “the department’s investment in data analytics produces outsized returns” in its fight against healthcare fraud. Learn more about th...
