The Challenges of Healthcare Fraud

The Challenges of Healthcare Fraud

Every year, billions of taxpayers’ dollars are wasted on healthcare fraud. Whether facilities make false claims, engage in Stark Law Violations, or commit home healthcare fraud, their actions have a negative impact on the healthcare industry and the country as a whole. The burden of healthcare fraud is shared by everyone in the country. Each year, more than $3.5 trillion is spent on health care expenditures in the United States. It is believed that between 3% and 10% of these costs are related to fraud. Having a deep understanding of health care fraud can help providers and patients recognize these actions to help combat the issue.

What Does Health Care Fraud Look Like?

The majority of health care fraud actions are committed by a small number of perpetrators. These people can pose as legitimate health care providers and serve patients by taking advantage of the confidence entrusted to them. Some common types of health care fraud include:

  • Billing for services that are never actually provided to patients. Providers will use patient information to submit claims or pad legitimate claims to look like they were provided more services or products than they actually were.
  • Billing for higher-cost services or products while rendering minimal services. For example, a health care provider may bill an insurance company for foot surgery when all they did was trimmed the patient’s nails.
  • Performing services that are medically unnecessary just to generate insurance payments to them.
  • Falsifying a patient’s diagnosis and medical record to justify the billing of services, tests, and products.
  • Unbundling when billing, which involves billing insurance companies for every step of a procedure separately rather than all together.
  • Accepting kickbacks for patient referrals.
  • Billing a patient for amounts in excess of co-payments so they can receive more money from the insurance company.
  • Waiving patient co-pays or deductibles for medical treatment by over-billing insurance carriers or insurance benefits

Engaging in health care fraud can have far-reaching impacts for patients across the country. Not only do these fraudulent actions cost billions of dollars each year, but they make it extremely challenging for patients to trust that they are receiving top-quality healthcare.

Healthcare Fraud Group Is Here For You

If you or your practice was accused of healthcare fraud, it is imperative that you understand the potential consequences. A conviction can have a devastating impact on your ability to practice. It can result in jail time and extensive fines. It is crucial that you reach out to an aggressive health care fraud defense attorney who can help you protect your legal rights.

We at Healthcare Fraud Group have extensive experience helping medical professionals accused of fraud and other illegal acts get the justice they deserve. We provide adequate and effective defense strategies that help those accused have their charges dismissed or drastically reduced. Contact our team today at (888)-402-4054 to get the representation you can trust.

Schedule a Confidential Initial Compliance Assessment with Our Federal Health Care Group