The IRE Resource Center is a major research library containing more than 23,250 investigative stories — both print and broadcast. These stories are searchable online or by contacting the Resource Center directly (573-882-3364 or rescntr@ire.org) where a researcher can help you pinpoint what you need. Browse or search the tipsheet section of our library below. Stories are not available for download but can be easily ordered by contacting the Resource Center:
Search results for "fraudulent billing" ...
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Home Health Hustler
This investigation exposed a woman using multiple identities to set up and operate fraudulent home health care businesses and bill the government. Their investigation found Irene Anderson, also known as Iya Edwards, was in the country illegally and ordered deported nearly twenty years previous, yet she was able to establish numerous home health care agencies and collect millions of dollars in government money. She received Medicare payments for patients who would not typically qualify for home care coverage and for patients who received no home health care at all. This story exposed lapses in federal healthcare and legal systems as well as in the state regulatory system home health care providers. The news team found several ex-employees who had reported fraud and abuse to the state, but nothing had been done. In fact, the Texas Department of Aging and Disability Services claimed it conducted an investigation and found nothing, clearing the way for Anderson to continue to fraudulently bill the federal government. The investigation triggered an arrest, a federal raid, criminal charges, repayment of millions of tax dollars and promises of legislative change.
Tags: Texas; home health care; fraud; Medicare fraud; public records
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Rent a Patient
In this hidden camera investigation, ABC News Primetime uncovers the nationwide medical insurance scam that sends healthy people to surgery for profit. So far, recruiting people to have unnecessary procedures done has cost the insurance industry billions of dollars in fraudulent claims. Recruiters pull people in with offers of free cosmetic surgery and, in many cases, they are required to have the expensive procedures far from home. "The story resulted in the indictment of one surgery center, where ABC News correspondent John Quinones was offered money to have surgery. On the day our report aired, the FBI raided that facility and three others."
Tags: medical insurance scams; suspicious claims; healthcare; cosmetic surgery; insurance fraud
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Taken for a ride
An L.A. area organized crime group fraudulently billed Medicare for more than 100 million dollars. Sources say the group started to recruit elderly patients 400 miles north, in the San Francisco Bay Area. In a lucrative scheme, recruiters lured mostly Vietnamese seniors all the way from San Jose to the bogus clinics on the Southland. The elderly citizens, many of whom don't speak a word of English, were bribed to come to the clinics. Once the seniors got to the clinics, the scammers obtained Medicare numbers and patient signatures, then billed Medicare and taxpayers for thousands of dollars in tests never performed.
Tags: TAPE; TRANSCRIPT; Medicare; fraudulent billing; organized crime; health clinics; healthcare fraud; medicare card; medicare statement; lien bills; medicare fraud; fake clinics; Dr. Laurie Magbanua
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Dental Woes
Tipped off by a series of complaints against Family Dental Care Associates, WCPO TV investigate further to bring out some starking revelations. The investigation reveals, apart from fraudulent billing practices, the low standards of cleanliness and hygiene maintained by FDCA. Parts of the investigation also focused on a state investigation by the Attorney General's office and relationships between the dental board's investigator and FDCA's cheif dentist, Dr. J Michael Fuchs.
Tags: dental chain; malpractice; patient care; sterilize; tape; transcript; 18:31
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Finding the Fat in State Contracts
The Mobile Register looks into "whether no-bid contracts entered into by the state of Alabama were in the public interest, focusing on state incentive packages to automakers and details of plans to build two warehouses for state agencies. (Eddie) Curran found instances of what appeared to be fraudulent billing, apparent conflicts of interest, payments of rates well above industry standards, questionable qualifications of professionals hired and consistent links between contractors and administration officials."
Tags: no-bid contracts; Alabama; state politics; local government; conflicts of interest; fraud; billing; industry standards; contractors
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Colliding head-on with Uncle Sam
The San Antonio Business Journal reports about "Abuse of power/racial targeting by prosecution team in insurance fraud case that was part of a national investigation called 'Operation Sudden Impact.' As part of that sweep, a San Antonio small business, The Pain Therapy Clinic, was raided and all of its records and computers confiscated - effectively putting it out of business. Some two years later, an indictment was finally handed down accusing the Iranian family that ran the clinic of engaging in a conspiracy to defraud insurance companies through a complex scheme of overbilling, fraudulent claims and staged auto accidents... The Iranian family alleges that they are the victims of a trumped up criminal case. Among the charges made by the family are that a federal prosecution team in San Antonio engaged in a pattern of abuse... (and) the FBI is only working against Iranians..."
Tags: Federal Bureau of Investigations; FBI; National Insurance Crime Bureau; framed; League of United Latin American Citizens; LULAC; NICB; FOIA
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Strange bills arise from Opticom calls
The Northwest Indiana Times found fraudulaent charges at pay telephones, and widespread disregard of FCC regulations. Opticom, a national operator services provider, was the focus. Fraudulent bills, false information among other things was discovered.
Tags: telephone services; bills; tariff filings
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No title (id: 12664)
A one-year investigation of fraudulent contrator dealings aided by officals in Beachwood City Hall leads to indictments of 12 people. The investigation shows two contractors padded their bills by hundreds of thousands of dollars from 1992 to 1994 and gave free or low-cost concrete driveways and landscaping work to city administrators. (Jan-Dec. 1995)
Tags: Grant Public corruption in Beachwood Ohio Contest entry Politics 54 pgs.
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Clinical Evidence
"PrimeTime Live exposed a scheme to loot the Federal Medicare program costing taxpayers billions. The segment showed on-tape bribes/kickbacks offered to an (undercover) 76-year-old Miami, Florida, Medicare recipient by recruiters for crooked clinic owners. Clinic owners then fraudulently billed Medicare for tens of thousands of unnecessary or never-performed procedures..."
Tags: VIDEOCLIP TAPE TRANSCRIPT Health care Fraud; Medicare claims senior citizens hidden camera
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Transport Life Health Coverage Fell Short of Some Agents' Claims
Asbury Park Press investigates insurance agents who fraudulently promised better health insurance than the company delivered, leaving policy holders with thousands of dollars worth of unpaid medical bills, June 3, 1990.
Tags: NJ; Transport Life; Medical Insurance