Brian Whitley, regional inspector general for evaluation and inspection at HHS, discusses the agency's recent multimillion-dollar recovery from electronic fraud transfer schemes and the impact of the schemes on Medicare and Medicaid programs, noting that two-thirds of states, Medicare contractors and managed care organizations interviewed by HHS OIG officials reported being targeted and that a third reported financial losses. Whitley shares recommendations made to CMS and notes that CMS will have to prioritize its focus after seeing its workforce reduced.

Janay Corbitt of Montgomery County, Ohio, has been sentenced to as many as nine years in prison for defrauding $1.5 million from Medicaid. According to the indictment, Corbitt stole people's identities to open and operate fake counseling agencies, as well as the credentials of licensed counselors to bill Medicaid for services that weren't provided.

Jordona Ndon, a nurse practitioner living in Virginia who previously practiced in Delaware, has agreed to a $50,000 settlement to resolve allegations that she ordered unnecessary orthotic braces. Officials say that Ndon signed thousands of orders for the braces for Medicare beneficiaries she never saw, and in many cases the orders were already filled in by unqualified telemarketers.

Forty-eight House Democrats have sent a letter to the Office of Management and Budget demanding the Department of Government Efficiency stop unauthorized use of artificial intelligence, particularly in handling sensitive data. The letter, led by Reps. Don Beyer, Mike Levin and Melanie Stansbury, cites data privacy and cybersecurity risks, and asks whether DOGE has used AI for decisions about federal employment or contracting.

Medicare spending on remote patient monitoring rose from $6.8 million in 2019 to $194.5 million in 2023, and spending on remote therapeutic monitoring grew from $2.2 million in 2022, when RTM codes were introduced, to $10.4 million in 2023, according to a report from the Peterson Center on Healthcare. Approximately 1% of Medicare beneficiaries are in a remote physiological monitoring program, and average billing duration has lengthened. The report recommends aligning coverage and reimbursement with clinical value, ensuring access to high-impact RPM services and improving data collection.

NHCAA's Platinum and Premier Supporting Members are leading providers of products and services to the health care anti-fraud industry, are valued partners who support NHCAA's mission, and have demonstrated outstanding commitment to the fight against health care fraud. Learn more about these companies on the Fraud Solutions Guide.

NHCAA Partner Webinars, available only to NHCAA Member Organizations, provide an opportunity to showcase your anti-fraud expertise through live training hosted on your preferred webinar platform. Partners receive and manage all registration data. NHCAA provides promotion for your webinar with two targeted emails and a spotlight on our website. For more information or to schedule a Partner Webinar, visit the Sponsorship Opportunities page on the NHCAA website or contact us at programs@nhcaa.org with any questions or ideas.