A pair of scammers from Queens is facing federal charges for allegedly defrauding public health programs of a combined $120 million, the U.S. Department of Justice (DOJ) reported on Monday. Inwoo Kim, also known as Tony Kim and Long Jin, 42, and Daniel Lee, also known as Daniel Yang, 56, both of Flushing, are alleged to have run an adult day care and pharmacy empire starting in 2016 based on scamming taxpayer-funded Medicaid and Medicare, to rake in an illegally obtained $120 million.
SAN FRANCISCO Kaiser Permanente affiliates will pay $556 million to settle a lawsuit that alleged the health care giant committed Medicare fraud and pressured doctors to list incorrect diagnoses on medical records to receive higher reimbursements, federal prosecutors said. The deal announced Wednesday came more than four years after the U.S. Department of Justice filed the legal claim in San Francisco that consolidated allegations made in six whistleblower complaints.
CMS announced the start of the "Crushing Fraud Chili Cook-Off Competition" on Aug. 19, calling it "a market-based research challenge" to identify emerging technologies that can "detect anomalies and trends in Medicare Fee-for-Service (FFS) claims data that can be translated into novel indicators of fraud." The agency said it is "prioritizing the use of innovative, data-driven approaches, including explainable AI/ML" that can analyze large datasets to "uncover unusual patterns, anomalies, or trends that may signal fraudulent activity."
