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Five Commonly Needed Medical Services Not Covered by Medicare

One mistake that many Medicare recipients make is assuming that all their basic medical needs are covered under Medicare. In fact, there are a lot of commonly needed medical services that Medicare does not pay for. By becoming informed about the coverage gaps in your Medicare policy, you are not…

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CareCore National, LLC to pay $54 Million for Fraudulently Overbilling

CareCore National, LLC and the U.S. Department of Justice entered into a settlement agreement, according to a May announcement. CareCore will pay $54 million to resolve a False Claims Act suit based on allegations it fraudulently billed government insurance programs. The business provides pre-authorization/pre-certification services to managed care plans. It…

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Cheat the System, Pay the Price: Pursuing Those Who Knowingly Violate Medicare Rules

There are few topics that will get people talking (and, inevitably, complaining) like health insurance.  The truth of the matter is that, in order to function efficiently and provide the best possible care to the largest possible audience, health insurance companies must have rules and guidelines.  Perhaps the context where…

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Focusing on the Victims: Medicare Fraud, Mental Health, and a Partial Hospitalization Program Scam

Who are the victims of Medicare fraud?  As a law firm specializing in health care fraud matters, we understand that question requires a multi-part answer.  At the broadest level, Medicare fraud is theft and the target is a taxpayer-funded government program, meaning every U.S. taxpayer is a victim.  Narrowing the…

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