Pharmacy Audit

Medicare, Medicaid, and pharmacy benefit manager (PBM) audits can result in substantial losses for pharmacies. If auditors uncover evidence—or apparent evidence—of overpayments, not only can they initiate recoupments, but they can potentially deny pending claims, impose pre-payment review of future claims, and impose other financial penalties as well.

Dr. Nick Oberheiden is an anti-money laundering lawyer at the national corporate compliance law firm Oberheiden P.C. Here, he summarizes what he think...

One avenue for whistleblowers to take to report fraud against the government is to file a qui tam lawsuit under the federal False Claims Act. These la...

Medicare, Medicaid, and pharmacy benefit manager (PBM) audits can result in substantial losses for pharmacies. If auditors uncover evidence—or appar...

Medicare pays billions of dollars in fraudulently billed claims each year despite the various tools the Medicare system has at its disposal. Because o...

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