CMS Director Mehmet Oz launches intensified audits of Medicare Advantage plans targeting fraud, waste, and upcoding as enrollment grows. Stronger oversight aims to sustain Medicare's financial health.
Two former Maryland police officers pleaded guilty to staging auto thefts and submitting falsified police reports in a scheme defrauding insurers of tens of thousands of dollars. Their actions reveal risks in insurance claim verification and fraud detection.
Two Maryland police officers pled guilty to orchestrating an auto insurance fraud scheme involving staged vehicle thefts and falsified police reports, resulting in significant fraudulent insurance payouts. Their sentencing highlights enforcement efforts against insurance fraud in law enforcement.
The DOJ has filed a False Claims Act complaint against GoHealth, alleging illegal kickbacks to brokers for Medicare Advantage enrollments, triggering a securities investigation and stock decline.
A phishing scam falsely claiming unclaimed life insurance policies is targeting consumers, warns the Better Business Bureau. Learn how to recognize and avoid these fraudulent insurance offers.
The DOJ files a lawsuit accusing insurers and brokerages of illicit kickbacks in Medicare Advantage plan enrollments, raising compliance and regulatory concerns.
Bene Market LLC and Seguro Medico LLC operated deceptive health and dental discount plan sales via a call center, raising compliance issues in insurance marketing.
Shelter Insurance adopts Shift Technology's AI-driven fraud detection tool to improve identification and investigation of auto and property insurance fraud, boosting operational efficiency and fraud mitigation in 20 U.S. states.
Henry Ford Health and MSU launch a Detroit medical research center amid a $3B project; CURE Auto Insurance discusses market innovation and fraud legislation in Michigan.
Medicare Advantage programs increase government spending by $84 billion annually due to payment structures and upcoding, impacting Medicare's fiscal sustainability.
