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Data Mining Healthcare Fraud

Arnall Golden Gregory LLP

Seventh Circuit Affirms Liability in AKS-Based FCA Suit But Vacates Award of Damages

The United States Court of Appeals for the Seventh Circuit recently considered a district court’s nearly $6 million judgment in a qui tam False Claims Act (“FCA”) suit based on Anti-Kickback Statute (“AKS”) violations. The...more

Maynard Nexsen

Is Bigger Always Better? A Closer Look at the Perils of Big Data Mining in Healthcare

Maynard Nexsen on

This article is the second in a series of three that will explore the topic of data mining and its ability to highlight potential healthcare fraud, as well as its effects on healthcare systems and medical providers. The...more

Maynard Nexsen

New Kid on the Block: The Rise of the Data Mining Whistleblower

Maynard Nexsen on

This article is the first in a series of three that will explore the topic of data mining and its ability to highlight potential healthcare fraud, as well as its effects on healthcare systems and medical providers.Data mining...more

Polsinelli

Proposed Rule to Strengthen State Medicaid Fraud Control Units

Polsinelli on

A recently published proposed rule expands the functions and responsibilities of state Medicaid Fraud Control Units (MFCUs). The rule was issued by the Centers for Medicare and Medicaid Services (CMS) and the Office of...more

Cooley LLP

Blog: Key Takeaways from Government Enforcement Panel at ACI Sunshine Conference

Cooley LLP on

Recently, representatives from the United States Attorney’s Office for the Northern District of Georgia, United States Attorney’s Office for the District of New Jersey, and Medicaid Fraud Control Unit (MFCU) for the Office of...more

McAfee & Taft

Brace for Medicaid data mining and recoupment demands

McAfee & Taft on

The federal Health and Human Services Office of Inspector General (OIG) is escalating its war against Medicaid fraud and abuse, just as it has over the past years with Medicare. The OIG’s focus has turned to early prevention...more

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