AI deepfake detection tool targets surge in synthetic medical claims fraud
US health plans are adopting new AI tools to detect manipulated medical records and diagnostic evidence as generative AI increases the...
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Aetna to pay $117.7M to settle Medicare Advantage fraud allegations
Aetna has agreed to pay $117.7 million to resolve allegations that it violated the False Claims Act by submitting or failing...
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Doctor denies knowing about rampant LA-area Medicare fraud using his provider number
On a busy, gritty street in suburban Los Angeles, the white one-story stucco building looked like any other. Among the apartments,...
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AI in Insurance Claims Processing: Emerging Trends and Applications
If you have ever filed an insurance claim, you know how it feels: calls on hold, forms to fill, days, sometimes...
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Winter Storm Season Is Prime Time for Home Repair Scams: Here’s How to Spot One
When a storm rolls through your neighborhood, the damage to your home might only be the beginning of your problems. Within...
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New York judge brings the hammer down on alleged staged car accident, insurance fraud ring
An alleged insurance fraud ring in New York State has been shut down in its attempts to receive money from insurers...
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$12.7M Medicaid fraud scheme exposes wider program concerns
Last week, a federal judge sentenced four people tied to fake substance-abuse treatment facilities in Kinston and Goldsboro to 14 year...
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CMS imposes equipment supplier moratorium; 3 sentenced to prison in fraud cases
Since CMS implemented a six-month nationwide moratorium on new Medicare enrollment for certain durable medical equipment suppliers, the Justice Department has announced at...
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War on Fraud Comes to New York, Addressing Medicare’s Skin Substitute Abuse, Important FDA Reform, and More
This week’s newsletter highlights several important developments in the fight to restore integrity to federal health programs. First, the Centers for...
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Ag supplier says farmers are delaying crop decisions
An ag input supplier says 2026 has been unusually quiet so far. Matt Oehmichen with Short Lane Ag Supply in Wisconsin...
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