Credentialing Chronicles
"Credentialing Chronicles" is the go-to podcast uncovering the hidden truths and scandals in healthcare credentialing, licensing, and compliance. Hosted by industry experts, we dive into real cases, juicy controversies, and insider knowledge that every persons needs to know! 🎙️🔥
Credentialing Chronicles
Episode 29 : Medicaid Manipulators
Fraud. Defendants... Shell companies. Federal crackdown.
This week on Credentialing Chronicles, Shannen & Nyleen go full investigative mode on the largest healthcare fraud takedown in U.S. history — Operation Gold Rush.
From catheters moved like burgers on a grill to braces billed for amputees, we’re exposing how Medicaid fraud has evolved into an industrialized business model. This isn’t fringe crime — it’s organized, automated, and devastating to the patients Medicaid was meant to protect.
🔥 In this episode:
- Why the OIG is now posting fraud busts on LinkedIn (and what that says about public deterrence)
- The infamous “1,000 leg braces” scheme — and how it slipped through the system
- How Operation Gold Rush raked in billions through stolen identities and shell suppliers
- What keeps DME fraud thriving (and why enforcement can’t keep up)
- The tools compliance, billing, and credentialing pros can use to stop the next scam before it starts
🧾 With $1.4B recovered and $14.6B exposed, this isn’t just a headline — it’s a wake-up call.
If you touch Medicaid oversight, healthcare billing, or credentialing, this episode proves: you’re part of the fix.
🎧 Listen now — and don’t forget to share, tag your compliance crew, and make some noise.
Fraud doesn’t hide anymore — and neither should your defenses.
#CredentialingChronicles #HealthcareFraud #OperationGoldRush #OIG #Compliance #MedicaidFraud #Credentialing #FraudPrevention
Resources Mentioned:
Open Payments
openpaymentsdata.cms.gov
Verify your Nurses' Credentials:
https://www.nursys.com/
🔎 Verify Your Doctor’s Credentials
✔️ State-Specific Medical Board License Lookup:
Find your state’s board here:
https://www.fsmb.org/contact-a-state-medical-board/
✔️ Medicare Exclusions List (LEIE) – Check if your provider is federally excluded:
https://oig.hhs.gov/exclusions/exclusions_list.asp
✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts
For Medical Staff Professional:
✔️ FSMB.org – Federation of State Medical Boards Physician Lookup:
https://www.fsmb.org/physician-license-lookup/
✔️ Hospital Websites:
Many hospitals have public directories listing credentialed medical staff. Look for a “Find a Doctor” or “Medical Staff Directory” page.
✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts
🔎 Wanna know if your doctor is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon
Because credentials do matter. 🩺✨
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