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More Than 100 Are Charged in Medicare Fraud Sweep
United States authorities have charged 107 people, including doctors and nurses, for trying to defraud the federal Medicare health care program for the elderly and disabled of about $452 million, the biggest Medicare fraud sweep to date, the Obama administration said Wednesday. At least 91 people were arrested in Miami; Houston; Baton Rouge, La.; and four other cities on a variety of charges, from submitting false billing for home health care, mental health services, H.I.V. infusions and physical therapy to money laundering and receiving kickbacks. Justice Department and Health and Human Services Department officials were unable to say how much Medicare actually paid out, but a review of 34 complaints and indictments found that the authorities were seeking to recover at least $59.5 million.
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Source: The New York Times
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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From Red Tape to Relief: Rewriting the Rules of Prior Authorization
June 23rd 2025Up to 257 million Americans could benefit from these prior authorization reforms that could have cross-market implications on health care plans administered through commercial insurers, Medicare Advantage, and Medicaid.
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