Compliance News Roundup: Kansas Medicaid Fraud Control Unit

Compliance News Roundup: Kansas Medicaid Fraud Control Unit

Posted by Healthicity
Aug 7, 2019 10:16:40 AM

1. Virginia Doctor Arrested on Federal Complaint - Dr. Raymond Michael Moore, a licensed medical doctor, was arrested this morning for obtaining schedule II and IV controlled substances by fraud or misrepresentation, failing to maintain proper records for schedule II and schedule IV controlled substances, and making false statements. The criminal complaint charges Moore, 61, of Wise, Va., with one count of acquiring, obtaining, or possessing schedule II and schedule IV controlled substances by misrepresentation, fraud, forgery, deception, or subterfuge, one count of failing to maintaining records for schedule II and schedule IV controlled substances received, delivered or shipped and one count of making false statements. Get the full scoop >>

2. Wisconsin Community Services, Inc. Agrees to Pay over $500,000 To Resolve False Medicare and Medicaid Billings - US Attorney Matthew D. Krueger announced today that Wisconsin Community Services, Inc. (“WCS”) agreed to pay $537, 904.33 to the United States and the State of Wisconsin to resolve false claims for prescription medications submitted by WCS to Medicare and Medicaid in violation of the False Claims Act, 31 U.S.C. §3729-3733. WCS is a not-for-profit corporation based in Milwaukee, Wisconsin, providing a range of services, including outpatient mental health services and an associated pharmacy. WCS voluntarily disclosed to the United States Attorney’s Office that one of its pharmacists submitted claims to Medicare and Medicaid that misrepresented the prescription drugs dispensed by WCS over several years. Get the full scoop >>

3. Deeper Than the Headlines: Kansas Medicaid Fraud Control Unit - In 2018, the OIG conducted an inspection of the Kansas MFCU covering fiscal years 2015 - 2017. The role of MFCUs is to investigate Medicaid fraud and patient abuse or neglect in facility settings, and then prosecute those cases or refer them to other prosecuting offices. Each MFCU receives a Federal grant equivalent to 90 percent for new Units and 75 percent of total expenditures for all other Units. Their findings can provide great insight into assessing Medicaid risks within own organizations. Get the full scoop >>

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