What's New

September 13, 2023

Puerto Rico Claimed Over $7 Million in Federal Reimbursement for Medicaid Capitation Payments Made on Behalf of Enrollees Who Were or May Have Been Deceased A-02-21-01005

Puerto Rico Claimed More Than $500 Thousand in Unallowable Medicaid Managed Care Payments for Enrollees Assigned More Than One Identification Number A-02-21-01004

The Substance Abuse and Mental Health Services Administration Did Not Ensure That Clinics Fully Complied With Federal Requirements When Awarding and Monitoring Certified Community Behavioral Health Clinic Expansion Grants A-02-21-02010

Enforcement Actions

September 12, 2023; U.S. Attorney's Office, District of Maryland

Frederick Medical Practice Pays The United States More Than $850,000 To Resolve Claims That It Inappropriately Billed For Medical Service

September 12, 2023; U.S. Attorney's Office, Western District of Missouri

KC Daycare Owner Pleads Guilty To $772,000 Fraud Scheme

September 11, 2023; U.S. Attorney's Office, District of Colorado

Colorado Psychiatry Practice And Owner Agree To Pay $1.9 Million To Settle Allegations Of Fraudulent Billing

What's Trending

1. Managed Care Featured Topic
2. Florida Did Not Refund $106 Million Federal Share of Medicaid Managed Care Rebates It Received for Calendar Years 2015 Through 2020
3. Medicare Improperly Paid Providers Millions of Dollars for Unlawfully Present Beneficiaries Who Received Services During 2009 Through 2011
4. Compliance Resources
5. Cambridge Internist Pays More Than $176,000 to the United States to Resolve False Claims Act Allegations that He Administered Medically Unnecessary Procedures