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The lawsuit filed in federal court in South Florida alleges that large call centers were used to enroll people into Affordable Care Act plans or to switch their coverage, all without their permission.
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Elizabeth Hernandez, 45, routinely billed more than 24 hours of “office visits” in a day and pocketed about $1.6 million, federal prosecutors said.
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In one case filed in the Southern District of Florida, investigators said they found nearly $2 billion in fraudulent telemedicine claims submitted to government-funded coverage programs like Medicare and Medicaid.
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The numbers issued by a SBA inspector general are much greater than previous projections and underscore how vulnerable the Paycheck Protection and COVID Economic Injury Disaster Loan programs.
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Agents are providing fraudulent information on applications for health plans. Those who are signed up are disqualified from other forms of free and low-cost care and risk disruptions in treatments.
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Some seniors got dozens of COVID tests they never ordered. Bad actors may have used seniors' Medicare information to improperly bill the federal government — and could do it again, investigators say.
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Arguments on Tuesday center on a powerful tool for fighting fraud in government contracts and programs. The case examines whether major pharmacies knowingly overcharged Medicare and Medicaid.
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A House bill would close one of a laundry list of oversight gaps revealed in a recent investigation of the system regulators use to ban fraudsters from billing government health programs.
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States are acting in the wake of a federal investigation into what officials say was a fraud scheme in which several now-closed South Florida nursing schools sold phony nursing diplomas and transcripts.
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Federal authorities say three South Florida nursing school participated in a wire fraud scheme that they say created an illegal shortcut for aspiring nurses to get licensed and find employment.