More than a dozen health care professionals in North Texas are accused of submitting hundreds of millions of dollars in false and fraudulent health care claims.
More than a dozen health care professionals in North Texas are accused of submitting hundreds of millions of dollars in false and fraudulent health care claims.
Physicians, nurses and other health care workers face an array of federal charges, from conspiracy to commit fraud to offering and accepting bribes. The charges are part of a sweeping federal investigation announced Tuesday that has led to charges against about 450 people, including 90 physicians, nationwide. Authorities say the fraudulent claims totaled $6.5 billion nationwide.
In North Texas, authorities say they have identified $365 million in fraudulent and false claims and have seized more than $35 million in cash, luxury vehicles and other assets.
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PROCUREMENT & EXPENDITURE (STOPPING KICKBACKS)
Procurement fraud usually involves inflated invoices or “fictitious” vendors.
- The Three-Way Match: Never pay an invoice unless you have matched the Purchase Order (PO), the Delivery Note (signed), and the Supplier Invoice.
- Vendor Master File Review: Review your vendor list annually. Look for suppliers with the same bank details or physical addresses as your employees.
- Dual Authorization: Implement a “Two-to-Sign” rule for all EFT payments above a certain threshold (e.g., R5,000).
- No “Cashing” of Checks: If you still use physical checks, strictly prohibit “Cash” as a payee and store blank checks in a dual-lock safe.