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The Medicare Advantage (Part C) and Part D Fraud Handbook is a reference for anti-fraud professionals. It presents industry best practices regarding processes, methods and resources to support fraud prevention, detection, corrective action, preliminary investigation and referral activities.Learn More
View these four brief educational videos that describe readily available data and information resources to support data analysis and FWA investigations. Specific examples show how to use the data to identify red flags of potential FWA among providers, pharmacies or beneficiaries.Learn More
Do you know how to prepare a strong fraud, waste and abuse (FWA) referral? Do you know how to use the data available within your organization during preliminary investigations of potential FWA? The new on demand training webinar Preparing Effective Referrals will help you build the knowledge and skills necessary to effectively combat Medicare Parts C and D FWA.Learn More
In this webinar, you will learn how to leverage the analytical methods, averages and measures identified in recent U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) reports to detect potential Part D fraud, waste and abuse (FWA) among prescribers, pharmacies and beneficiaries.Watch Now!
This job aid provides explains how to leverage the analytical methods, averages and measures identified in recent U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) reports to detect potential Part D fraud, waste and abuse (FWA).Learn More
These two brief educational videos will teach you about the benefits and the impacts of the transition to the ICD-10 coding system. Click learn more to watch the video.Learn More
SPRINGFIELD, Mo. – Tammy Dickinson, United States Attorney for the Western District of Missouri, announced that an oncologist who operated a clinic in Joplin, Mo., was sentenced in federal court today for dispensing foreign, misbranded drugs to his cancer patients. (7/15/2015)See all Fraud Stories
A federal judge on Wednesday acquitted a physician on charges that he had pocketed monthly kickbacks of $4,000 from Sacred Heart Hospital in exchange for referring patients to the now-shuttered facility. (7/15/2015)See all Fraud Stories
A woman accused of visiting hundreds of medical facilities around the country to buy unnecessary prescription drugs with her Medicare card has been indicted in federal court in North Dakota.