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DME Supplier Audits, Fraud Allegations, and Consequences

When your Durable Medical Equipment (DME) business faces government scrutiny, it can threaten reimbursement, enrollment, and even your freedom. CMS, MACs, RACs, UPICs, OIG, and the DOJ actively pursue suspected patterns of DME equipment fraud to protect Medicare and Medicaid funds. What may begin as an administrative audit can quickly escalate into civil or criminal [...]

What Should I Do When FBI Agents Show Up at My Home to Interview Me?

You’ve just arrived home after work. You’re about to begin relaxing when FBI agents show up at your home, and you hear a knock at the door. The Federal Bureau of Investigation agents want to come in and ask you a few questions. What steps should you take next? Why FBI Agents Visit You at [...]

Grand Jury Subpoenas in Healthcare Fraud Cases – What Medical Professionals Need to Know

Grand jury subpoenas are a court order compelling someone to testify or produce evidence for a grand jury investigation to determine if criminal charges are warranted. This post explains how healthcare professionals should respond to a healthcare grand jury subpoena. [...]

Why Healthcare Practice Owners and Providers Receive Target Letters and What to Do Next

Data shows the total new government and whistleblower healthcare fraud matters opened under the False Claims Act reached an all-time high of 1,402 in 2024. Healthcare practice owners across the United States are facing growing scrutiny from federal agencies like the Department of Justice (DOJ), the Office of Inspector General (OIG), and the FBI. A [...]

The Triggers for Medicare Fraud Investigations

The United States National Healthcare Anti-Fraud Association has new data. It shows that taxpayers lose more than $100 billion every year because of Medicare fraud. The scale of fraud and the rising number of fraud cases have made Medicare fraud investigations a priority for the Office of the Inspector General at the Department of Health [...]

What is an OIG Healthcare Fraud Investigation?

OIG (Office of Inspector General) investigations are independent inquiries conducted by oversight offices within government agencies to detect and prevent fraud, waste, abuse, and mismanagement. This guide is to help professionals facing an OIG investigation understand the next steps and the defense options. [...]