Justin C. Danilewitz

The Report highlights the important role of MFCUs in investigating and prosecuting Medicaid provider fraud, patient abuse, and neglect, and the results of the MFCUs’ work, including in obtaining healthcare fraud criminal convictions, exclusions from federal programs, and civil settlements and recoveries.

HHS-OIG shares findings from its review of potential fraud, waste, and abuse in Medicare billing for telehealth visits in the first year of the pandemic.

Many schemes involve allegations of orders or prescriptions for medically unnecessary DME, genetic testing, wound care, or prescriptions for medication, each resulting in reimbursement from a Federal health care program.

The majority concluded that the mental intent requirement does indeed apply not only to the conduct in issuing a prescription but also to a prescriber’s awareness of whether the prescription is authorized.