(FOX NEWS)
ATLANTA – Georgia officials are highlighting new Medicaid fraud cases tied to a nationwide law enforcement effort that investigators say uncovered billions of dollars in alleged health care fraud across the country.
What we know:
Attorney General Chris Carr on Tuesday announced a federal indictment against an Atlanta physician and a separate civil settlement involving a psychiatric practice, both connected to Georgia’s participation in the U.S. Department of Justice’s National Health Care Fraud Takedown.
The announcement comes as federal authorities revealed charges against 455 people nationwide, including dozens of doctors and other licensed medical professionals. Investigators allege the various schemes involved more than $6.5 billion in fraudulent claims submitted to government and private health care programs.
RELATED: 455 charged in health care fraud…
PAYROLL & HR CONTROLS (PREVENTING “GHOST” SCHEMES)
Payroll fraud is often the hardest to detect because it “looks” like a normal business expense.
- Segregation of Duties (SoD): The person who adds new employees to the system must not be the same person who approves the monthly pay run.
- Mandatory Vacation Policy: Require all financial and HR staff to take 5–10 consecutive days of leave annually. Fraud often surfaces when the perpetrator isn’t there to “hide” the trail.
- Ghost Employee Audit: Perform a quarterly “Headcount Reconciliation” where managers must physically verify every name on their payroll list exists.
- Self-Pay Blocking: Ensure the payroll software has a hard-coded block preventing administrators from editing their own salary or bank details.