Nebraska pharmacist pleads guilty to largest fraud scheme in state history; Indianapolis man sentenced to 46 months for fraud and identity theft;

News From Around the Web

> A Nebraska pharmacist pleaded guilty last week to the state's largest healthcare fraud scheme to date, in which he stole $14.4 million from the Medicaid program, according to the Lincoln Journal Star. Scott Tran, owner of Tran Pharmacy, submitted hundreds of fraudulent claims for a solution used in inhalers prescribed to children with cystic fibrosis. The scheme was discovered by an FBI agent in Lincoln who found Tran submitted nearly 400 claims for the medication in a six-year period from six physicians who never prescribed the drug. Article

> An Indianapolis man was sentenced to nearly four years in prison for orchestrating a scheme in which he bought used wheelchairs on eBay and Craigslist, removed the serial number and submitted bills to Medicare, Medicaid and Anthem Blue Cross as if they were new. Ronald Reed, who owned Benchmark Mobility, frequently sold wheelchairs that were broken. During his trial, Reed also sent false documents and a stolen identity to a finance company in an effort to secure $30,000. Announcement

> A Georgia hospice provider paid $3 million to settle allegations that it submitted false claims to Medicare for patients who were not terminally ill. Guardian Hospice of Georgia LLC, which also went by Guardian Home Care Holdings Inc. and AccentCare Inc., failed to train staff and medical directors to adhere to hospice eligibility requirements, allegedly submitted claims for beneficiaries whom it knew were not terminally ill, and set aggressive targets to recruit patients. Announcement

Health Payer News

> Workplace wellness programs are having company employees undergo biometric blood testing that screens for potential health risks like high cholesterol or high blood sugar, leading some health experts to wonder if the programs are driving up the cost of healthcare through over-testing and over-treating. Experts say the programs sometimes are "one-size-fits-all" and do not account for age or other risk factors, and could lead to false positives or false negatives. Article

> Florida Gov. Rick Scott (R) is calling for hospitals to disclose their rates for medical procedures, along with how much they are reimbursed by insurance companies. Several months ago, Scott pitted himself against providers by asking hospitals to turn over financial information in relation to how hospitals charge the state's Medicaid program. Now he wants patients to be able to contest bills that appear too high. Article

And finally… Proof that you should always listen to your grandmother, even when it involves choking a grizzly bear. Article

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