Mo. attorney general recovers over $2.6M in fraudulent claims in 6 months | 3 La. nurses sentenced to probation in $30M Medicare fraud | Ark. woman gets probation for defrauding Medicaid
September 14, 2017
NHCAA SmartBrief
Top Story
Mo. attorney general recovers over $2.6M in fraudulent claims in 6 months
More than $2.6 million worth of fraudulent Medicaid payments was recovered by the Missouri Attorney General's Office in the first six months of 2017, according to Attorney General Josh Hawley. In partnership with other authorities, Hawley entered settlement deals with six health care providers, including Omnicare, IPC Healthcare and CareCore National.
KFVS-TV (Cape Girardeau, Mo.) (9/13),  KMIZ-TV (Columbia, Mo.) (9/13) 
LinkedIn Twitter Facebook Google+ Email
Stop the flow of healthcare fraud…with technology, data and advanced analytics
LexisNexis® InstantID® for Healthcare is a unique approach to data and identity analytics that provides significantly more insight by going well beyond the basic review process. Learn more.
Law Enforcement & The Courts
3 La. nurses sentenced to probation in $30M Medicare fraud
Louisiana residents Suprenia Washington, Erica Edwards and Jeff Koon were each sentenced to serve two years of probation and were each ordered to pay approximately $2,000 in restitution after pleading guilty to single counts of health care fraud. Washington, Edwards and Koon, former registered nurses at Abide Home Care Services in Louisiana, were involved in a $30 million Medicare fraud scheme at Abide, authorities say.
Department of Justice (9/13) 
LinkedIn Twitter Facebook Google+ Email
Ark. woman gets probation for defrauding Medicaid
Shirley Contreras, a resident of Pocahontas, Ark., was sentenced to a three-year probation term and was ordered to pay restitution of $5,514.04 plus fines and court costs after pleading guilty to Medicaid fraud.
Newton County Times (Jasper, Ark.) (subscription required) (9/13) 
LinkedIn Twitter Facebook Google+ Email
Owner of Fla. nursing home where 8 died during Irma has history of health fraud
Dr. Jack Michel, owner of Florida-based nursing home The Rehabilitation Center at Hollywood Hills, where eight people died during a power outage due to Hurricane Irma, was previously charged with health care fraud, according to federal prosecutors. Michel, along with several co-defendants, agreed to pay $15.4 million in 2006 to settle accusations that he received kickbacks for referring patients to his Miami-based hospital, Larkin Community Hospital, for unnecessary treatments.
Sun-Sentinel (Fort Lauderdale, Fla.) (9/13) 
LinkedIn Twitter Facebook Google+ Email
Policy & Regulatory News
Tools & Technology
Expert warns about 3 cybersecurity trends in health care
Expert warns about 3 cybersecurity trends in health care
(Adam Berry/Getty Images)
There will be new types of cyberattacks against medical devices such as insulin pumps, which could be shut down by hackers if a ransom is not paid, said Michael Daniel, president of the Cyber Threat Alliance, at the Healthcare Security Forum. Daniel also warned about trends toward greater collateral damage involving hospitals, along with data corruption, which is a "more difficult problem to solve because getting back to ground truth is incredibly difficult."
Healthcare IT News (9/12) 
LinkedIn Twitter Facebook Google+ Email
Australian researchers develop AI tool for diagnosing diabetic retinopathy
The Commonwealth Scientific and Industrial Research Organization in Australia reported the success of a trial of Dr Grader, an eye-screening tool that uses artificial intelligence for early diagnosis of diabetic retinopathy. The trial, which involved 187 diabetes patients, found that the technology was as effective in identifying signs and classifying the severity of the condition as a human specialist.
ZDNet (9/11) 
LinkedIn Twitter Facebook Google+ Email
Health Insurance Industry News
US uninsured rate fell to record low in 2016
A Census Bureau report found that the percentage of Americans who were uninsured fell to a record low of 8.8% in 2016 from 9.1% in 2015. Last year was the third consecutive year the uninsured rate declined, a trend that started in 2014 when the majority of the Affordable Care Act's coverage provisions were implemented.
Politico (9/12),  The Hill (9/12) 
LinkedIn Twitter Facebook Google+ Email
Medical News
NHCAA Webinar: Utilizing Pharmacy Analytics
Earn 2 CPEs by joining NHCAA on Wednesday, Sept. 27, when faculty will review five pharmacy schemes that can be easily found through data mining, including how to find, investigate and resolve these cases. Experts will showcase how to properly analyze real cleansed data to see aberrant patterns and help attendees understand how these methods can be replicated. Register today!
LinkedIn Twitter Facebook Google+ Email
Showcase your solution at ATC
Don't miss your opportunity to reach key decision-makers, meet with potential business partners, and to see what others are offering. Plan to become an exhibitor and sponsor at this year's ATC & Anti-Fraud Expo, Nov. 14-16 in Orlando. Visit the Anti-Fraud Expo website to learn more.
LinkedIn Twitter Facebook Google+ Email
Learn more about NHCAA:
About NHCAA | Join NHCAA | Education & Training Opportunities
About the AHFI Program | Career Connection
I would rather work with five people who really believe in what they are doing ... than five hundred who can't see the point.
Patrick Dixon,
business consultant
LinkedIn Twitter Facebook Google+ Email
Presenting Sponsor:
Sign Up
SmartBrief offers 200+ newsletters
Learn more about the SmartBrief audience
Subscriber Tools:
Contact Us:
Advertising  -  Deanie Griffin
Partner Relations Manager  -  Lauren Barr
Editor  -  Tara Rosenzweig
Mailing Address:
SmartBrief, Inc.®, 555 11th ST NW, Suite 600, Washington, DC 20004
© 1999-2017 SmartBrief, Inc.®
Privacy policy |  Legal Information