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Medicare fraud

Index Medicare fraud

In the United States, Medicare fraud is the claiming of Medicare health care reimbursement to which the claimant is not entitled. [1]

34 relations: Adam B. Resnick, Armenian Power, Arrest, Baton Rouge, Louisiana, Benefit fraud in the United Kingdom, Brooklyn, Congressional Budget Office, Detroit, False Claims Act, Federal Bureau of Investigation, Florida, Hospital Corporation of America, Houston, Johnson & Johnson, Kickback (bribery), Medicaid, Medicare (United States), Medicare Fraud Strike Force, Miami, Miami–Dade County, Florida, NPR, Nursing home care, Office of Inspector General, U.S. Department of Health and Human Services, Office of Management and Budget, Patient Protection and Affordable Care Act, Qui tam, Rick Scott, Robert Mueller, United States Attorney, United States Department of Justice, United States Federal Sentencing Guidelines, Whistleblower, Zone Program Integrity Contractor, 2010 Medicaid fraud.

Adam B. Resnick

Adam B. Resnick (born March 10, 1972) is an American health care entrepreneur, public speaker, author, and professional whistleblower.

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Armenian Power

Armenian Power, also known as West Side AP XIII, AP, the Armenian Mob, or Armenian Mafia is an Armenian American criminal organization and street gang located in Los Angeles County, California.

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Arrest

An arrest is the act of apprehending a person and taking them into custody, usually because they have been suspected of committing or planning a crime.

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Baton Rouge, Louisiana

Baton Rouge is the capital of the U.S. state of Louisiana and its second-largest city.

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Benefit fraud in the United Kingdom

Benefit fraud is a form of welfare fraud as found within the system of government benefits paid to individuals by the welfare state in the United Kingdom.

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Brooklyn

Brooklyn is the most populous borough of New York City, with a census-estimated 2,648,771 residents in 2017.

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Congressional Budget Office

The Congressional Budget Office (CBO) is a federal agency within the legislative branch of the United States government that provides budget and economic information to Congress.

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Detroit

Detroit is the most populous city in the U.S. state of Michigan, the largest city on the United States–Canada border, and the seat of Wayne County.

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False Claims Act

The False Claims Act, also called the "Lincoln Law") is an American federal law that imposes liability on persons and companies (typically federal contractors) who defraud governmental programs. It is the federal Government's primary litigation tool in combating fraud against the Government. The law includes a qui tam provision that allows people who are not affiliated with the government, called "relators" under the law, to file actions on behalf of the government (informally called "whistleblowing" especially when the relator is employed by the organization accused in the suit). Persons filing under the Act stand to receive a portion (usually about 15–25 percent) of any recovered damages. As of 2012, over 70 percent of all federal Government FCA actions were initiated by whistleblowers. Claims under the law have typically involved health care, military, or other government spending programs, and dominate the list of largest pharmaceutical settlements. The government recovered $38.9 billion under the False Claims Act between 1987 and 2013 and of this amount, $27.2 billion or 70% was from qui tam cases brought by relators.

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Federal Bureau of Investigation

The Federal Bureau of Investigation (FBI), formerly the Bureau of Investigation (BOI), is the domestic intelligence and security service of the United States, and its principal federal law enforcement agency.

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Florida

Florida (Spanish for "land of flowers") is the southernmost contiguous state in the United States.

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Hospital Corporation of America

Hospital Corporation of America (HCA) is an American for-profit operator of health care facilities that was founded in 1968.

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Houston

Houston is the most populous city in the U.S. state of Texas and the fourth most populous city in the United States, with a census-estimated 2017 population of 2.312 million within a land area of.

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Johnson & Johnson

Johnson & Johnson is an American multinational medical devices, pharmaceutical and consumer packaged goods manufacturing company founded in 1886.

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Kickback (bribery)

A kickback is a form of negotiated bribery in which a commission is paid to the bribe-taker in exchange for services rendered.

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Medicaid

Medicaid in the United States is a joint federal and state program that helps with medical costs for some people with limited income and resources.

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Medicare (United States)

In the United States, Medicare is a national health insurance program, now administered by the Centers for Medicaid and Medicare Services of the U.S. federal government but begun in 1966 under the Social Security Administration.

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Medicare Fraud Strike Force

The Medicare Fraud Strike Force is a multi-agency team of United States federal, state, and local investigators who combat Medicare fraud through data analysis and increased community policing.

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Miami

Miami is a major port city on the Atlantic coast of south Florida in the southeastern United States.

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Miami–Dade County, Florida

Miami-Dade County is a county located in the southeastern part of the U.S. state of Florida.

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NPR

National Public Radio (usually shortened to NPR, stylized as npr) is an American privately and publicly funded non-profit membership media organization based in Washington, D.C. It serves as a national syndicator to a network of over 1,000 public radio stations in the United States.

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Nursing home care

Nursing homes are a type of residential care that provide around-the-clock nursing care for elderly people.

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Office of Inspector General, U.S. Department of Health and Human Services

The Office of Inspector General (OIG) for the United States Department of Health and Human Services (HHS) is charged with identifying and combating waste, fraud, and abuse in the HHS’s more than 300 programs, including Medicare and programs conducted by agencies within HHS, such as the Food and Drug Administration, the Centers for Disease Control and Prevention, and the National Institutes of Health.

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Office of Management and Budget

The Office of Management and Budget (OMB) is the largest office within the Executive Office of the President of the United States (EOP).

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Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act, often shortened to the Affordable Care Act (ACA) or nicknamed Obamacare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010.

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Qui tam

In common law, a writ of qui tam is a writ whereby a private individual who assists a prosecution can receive all or part of any penalty imposed.

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Rick Scott

Richard Lynn Scott (born December 1, 1952) is an American businessman and politician serving as the 45th and current Governor of Florida since 2011.

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Robert Mueller

Robert Swan Mueller III (born August 7, 1944) is an American attorney who served as the sixth Director of the Federal Bureau of Investigation from 2001 to 2013.

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United States Attorney

United States Attorneys (also known as chief federal prosecutors and, historically, as United States District Attorneys) represent the United States federal government in United States district courts and United States courts of appeals.

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United States Department of Justice

The United States Department of Justice (DOJ), also known as the Justice Department, is a federal executive department of the U.S. government, responsible for the enforcement of the law and administration of justice in the United States, equivalent to the justice or interior ministries of other countries. The department was formed in 1870 during the Ulysses S. Grant administration. The Department of Justice administers several federal law enforcement agencies including the Federal Bureau of Investigation (FBI), and the Drug Enforcement Administration (DEA). The department is responsible for investigating instances of financial fraud, representing the United States government in legal matters (such as in cases before the Supreme Court), and running the federal prison system. The department is also responsible for reviewing the conduct of local law enforcement as directed by the Violent Crime Control and Law Enforcement Act of 1994. The department is headed by the United States Attorney General, who is nominated by the President and confirmed by the Senate and is a member of the Cabinet. The current Attorney General is Jeff Sessions.

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United States Federal Sentencing Guidelines

The Federal Sentencing Guidelines are rules that set out a uniform sentencing policy for individuals and organizations convicted of felonies and serious (Class A) misdemeanors in the United States federal courts system.

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Whistleblower

A whistleblower (also written as whistle-blower or whistle blower) is a person who exposes any kind of information or activity that is deemed illegal, unethical, or not correct within an organization that is either private or public.

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Zone Program Integrity Contractor

The Zone Program Integrity Contractor (ZPIC) is an entity established in the United States by the Centers for Medicare & Medicaid Services (CMS) to combat fraud, waste and abuse in the Medicare program.

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2010 Medicaid fraud

The 2010 Medicaid fraud was a case of Medicaid fraud carried out by an Armenian-American organized crime group called the Mirzoyan-Terdjanian Organization.

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Medicare Fraud.

References

[1] https://en.wikipedia.org/wiki/Medicare_fraud

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