Last February, 23 individuals were charged with healthcare fraud involving $61.5 million in Medicare schemes. This complex, illegal scheme exposed patients to unnecessary testing and physician services and took advantage of vulnerable populations who depend on Medicare for crucial medical services. Unfortunately, this isn’t the only time healthcare fraud has been an issue. Direct Care Innovations works tirelessly to provide a reliable and trustworthy business management platform for your direct care agency. With our robust healthcare software system, we do our best to help your agency avoid unethical and fraudulent situations like the ones listed below.
In unsealed court documents regarding this case, several individuals were charged with allegedly committing healthcare fraud throughout metro Detroit. The individuals include home health agency owners, patient recruiters, lab management companies, and various agency staff such as medical assistants and registered nurses. The defendants billed Medicare for medically unnecessary services or services that were never provided, paid bribes and unlawful kickbacks to co-conspirators, and falsely certified patients as homebound. They were also charged with making illegal payments to patient recruiters and receiving referral fees for ordering the highest-reimbursing services.
The Department of Health and Human Services (DHHS), the FBI Criminal Investigative Division (CID), the IRS Criminal Investigation Department, and fellow law enforcement partners worked together to investigate the alleged healthcare scheme and bring forth pending charges against the defendants. According to Luis Quesada, Assistant Director of the FBI’s CID, “Fraudsters look to orchestrate their schemes at the cost of our healthcare systems, patients, and taxpayers.” Mario Pinto, Special Agent in Charge of the DHHS Office of Inspector General, stated that “those who attempt to defraud Medicare often do so at the risk of . . . disregarding the health and well-being of patients.” State and federal partners are dedicated to protecting Medicare recipients from fraudulent and destructive care and holding those responsible for their criminal actions.
Direct Care Innovations’ state-of-the-art healthcare management software is designed to provide accountability within various agencies and meticulous oversight of staff and services. Our employee time and attendance software offers real-time visibility of time entered by direct care staff, agency approvals for all employees, and a system of accountability dashboards. Our EVV toolkit meets the requirements of the 21st Century Cures Act. It also features GPS-enabled location tracking, valuable Geofencing, tracking of travel time, and real-time notifications of the clock-in and clock-out for shift time tracking. With our configurable settings and available modules, organizations can apply flexible business rules unique to their staff and services.
We are happy to demonstrate how our integrative healthcare management system can provide the secure, all-in-one solution your agency needs. Contact one of our professionals by calling (480) 295-3307 or request a sales demo today.
Source: “Twenty-Three Individuals Charged in $61.5 Million Medicare Fraud Schemes.” Press Release. Office of Public Affairs. U.S. Department of Justice, 07 Feb. 2023. Web. 01 Apr. 2024.Direct Care Innovations specializes in collaborating nationwide with self-directed agencies, also known as consumer-directed agencies.…
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