Charles Ornstein

The fraud scheme began to unravel last fall, with the discovery of a misdirected stack of bogus prescriptions and a suspicious spike in Medicare drug spending tied to a doctor in Key Biscayne, Fla.

Now it's led to two guilty pleas, as well as an ongoing criminal case against ...

Over the past couple of months, media organizations including ProPublica have been busy dissecting data released by Medicare on payments made to health professionals in 2012.

We've uncovered unusual billing patterns: doctors who only bill for the most complicated and high-priced office visits, and ambulance companies in ...

To grasp Medicare's staggering bill for ambulance rides in New Jersey, just visit the busy parking lot of the DaVita St. Joseph's dialysis clinic in Paterson.

More than 20 ambulances were parked outside on a recent morning there. Emergency medical technicians wheeled patients in and out on stretchers. As soon ...

Medicare spent $6.7 billion too much for office visits and other patient evaluations in 2010, according to a report from the inspector general of the Department of Health and Human Services.

But in its reply to the findings, the Centers for Medicare and Medicaid Services, which runs Medicare, said ...

The federal government has granted itself potent new authority to expel physicians from Medicare if they are found to prescribe drugs in abusive ways, following through on a proposal issued earlier this year.

Under the rule finalized Monday, the Centers for Medicare and Medicaid Services also will compel health ...

Office visits are the bread and butter of many physicians' practices. Medicare pays for more than 200 million of them a year, often to deal with routine problems like colds or high blood pressure. Most require relatively modest amounts of a doctor's time or medical know-how.

Not so for Michigan ...

In August 2011, federal agents swept across the Detroit area, arresting doctors, pharmacists and other health professionals accused of running a massive scheme to defraud Medicare.

The following month, several of those arrested, including psychiatrist Mark Greenbain and podiatrist Anmy Tran, were suspended from billing the state's Medicaid program ...

An internal review by the University of Illinois has found that an advertisement in which a university surgical team endorsed a pricey surgical robot violated school policies.

Though the team acted "in good faith," the review concluded, the episode pointed to the need for clearer rules and stronger enforcement.

...

The sharp decline in payments coincides with increased scrutiny of drug marketing. Later this year, federal law will also require that drugmakers disclose the amount of money they give to doctors.

Flipping through The New York Times magazine a few Sundays ago, former hospital executive Paul Levy was taken aback by a full-page ad for the da Vinci surgical robot.

It wasn't that Levy hadn't seen advertising before for the robot, which is used for minimally invasive surgeries. It was that ...

The federal government said last week that it would begin releasing data on physician payments in the Medicare program. Somehow, the move seems to have ticked off both supporters and opponents of broader transparency in medicine.

Doctor groups, for their part, are worried that the information to be ...

Medicare plans to arm itself with broad new powers to better control — and potentially bar — doctors engaged in fraudulent or harmful prescribing, following a series of articles detailing lax oversight in its drug program.

The Centers for Medicare and Medicaid Services described the effort Monday in what's known ...