Compliance News Roundup: Proactive Data Mining

1. Healthcare Employee Sentenced to Prison for Fraud Scheme - “A Montgomery, Alabama woman was sentenced today to 26 months in prison for her involvement in a stolen identity refund fraud scheme, announced Principal Deputy Assistant Attorney General Caroline D. Ciraolo, head of the Justice Department’s Tax Division, and U.S. Attorney George L. Beck Jr. of the Middle District of Alabama.” Read more here: https://www.justice.gov/opa/pr/former-healthcare-employee-sentenced-prison-role-stolen-identity-refund-fraud-scheme

2. Pain Management Physician Resolves False Claim Act Allegations - “The U.S. Attorney’s Office for the Northern District of Georgia announced that pain management physician Dr. Anthony Clavo has agreed to the entry of a consent judgment for $430,000 plus interest to resolve allegations that he violated the False Claims Act by billing Medicare, Medicaid, and TRICARE for medically unnecessary services. The federal government’s portion of the consent judgment is $322,407, and the State of Georgia’s portion is $107,593.”
Read more here: https://www.justice.gov/usao-ndga/pr/pain-management-physician-resolves-false-claims-act-allegations

3. Deeper Than the Headlines: Proactive Data Mining - “Though whistleblower settlements don’t necessarily seem to be slowing down, it does seem that the government is announcing more and more settlements that appear to have originated from government data mining as opposed to whistleblowers.” Read more here: Deeper Than the Headlines: Proactive Data Mining