About the Author
Bill Fox, former Deputy Chief of Economic and Cyber Crime at the Philadelphia District Attorney’s office and a Special Assistant U.S. Attorney in Philadelphia is responsible for executive leadership and vision for the Health Care Insight Exchange Blog.
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May
07
The Silver Lining of Extending the ICD-10 Deadline
There is no question that the recently proposed rule that would delay implementation of ICD-10 by one full year will add dollars to what is already estimated to be one of the most costly implementations in the history of the …
Posted in General, Health Information Technology
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Apr
30
Medicaid Eligibility to Expand: Ready or Not, Here They Come
If current economic conditions continue, Medicaid enrollment will likely remain at record levels until 2014, when the healthcare reform-driven coverage expansion will then swell the rolls even further. The current health care proposals before Congress would make Medicaid available to …
Apr
23
Tip of the Iceberg
How many times have you heard the expression “the tip of the iceberg” when referring to fraud, waste and abuse in health care? We hear this expression several times each day. If 3 to 10 percent of health care spending …
Feb
16
The ICD-10 – Fraud Friend or Foe?
Fraud, waste and abuse costs you and I over $700 Billion annually, which equates to almost one third of total healthcare spend. Unfortunately, only about 5 percent of these dollars lost to fraud are ever recovered, mainly because providers have …
Oct
18
Swimming with the Sharks
A remora is a fish that is fairly easy to find. But when you see one you know something else much more dangerous is close by—sharks. One of the more interesting functions of good social network analytics modeling is to …
Oct
11
The Shifting Tide of Health Care Fraud and Abuse
Health care fraud and abuse affects some of the biggest companies and governmental agencies in the country – those with budgets and businesses measured in multi-billion dollar numbers. Ironically the big news headlines seem to always have to do with …
Posted in Fraud, Waste and Abuse, General
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