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The Week in Health Fraud: Tips for Your Own Reporting

The Week in Health Fraud: Tips for Your Own Reporting

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Medicare fraud, Barbara Feder Ostrov, Jacques Roy, reporting on health, health journalism

It's turning out to be quite the week for health fraud stories.

On Tues., federal officials arrested a Texas doctor and six associates in a home health care scheme that allegedly bilked Medicaid and Medicare out of a whopping $375 million. Here's a nice detail from the story by New York Times reporter Katie Thomas:

It was so brazen, (prosecutors) said, that it involved registering homeless people for home health care services they never received.

Today, the New York Post's Bruce Golding vividly reports on another high-profile series of health fraud arrests (you can read a more measured account here):

A brazen gang of Russian crooks was busted today for allegedly running a record-setting, $275 million fraud that exploited New York's "no-fault" auto-accident law.

The ring -- dubbed the "No-Fault Organization" -- worked with a "cadre of corrupt doctors" to set up more than 100 phony medical clinics across the city, Manhattan U.S. Attorney Preet Bharara said.

Time to consult the thesaurus for alternatives to "brazen?" Perhaps.

But the two stories should pique your interest in what's going on with health fraud enforcement at the national and state levels – and what might be happening in your own community

The Texas arrest of Canadian doctor Jacques Roy may have been sweet vindication for U.S. Health and Human Services secretary Kathleen Sebelius. She announced earlier this month that the feds in 2011 recovered $4.1 billion in fraudulent Medicare payments, in part by relying on an expensive new computerized Medicare fraud detection system that has been heavily criticized for its high costs for its lack of performance.

Want to look into possible health fraud cases in your community? Antidote blogger William Heisel has written extensively on this topic, and I've listed some of his key posts below.

Reporting Resources:

Q&A with Terri Langford, Part 1: Driving the Medicare Money Trail

Q&A with Terri Langford, Part 2: Finding the Medicare Stories Everyone Wants to Read

The False Claims Act: Pedicures passing as medicine among priceless stories to be found

The False Claims Act: Go court hopping when shopping for fraud stories

The False Claims Act: The law that makes fraud whistles blow


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Here's another good resource for reporting on health fraud: this webcast from the Alliance for Health Reform:

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Instability and the prospect of sharp premium increases are roiling health exchanges across the country. This webinar will put the latest news developments in context, discuss the ways in which GOP plans may impact the health exchange markets, and offer advice for reporters covering this story in their region. Sign up here!


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