Health Care Fraud

Health Care Fraud

Introduction

Healthcare fraud is a crime in which an individual or a company seeks to gain illegal profits through making false health care claims. The insurance company or the government organization such as Medicare is defrauded in this way. Health care fraud occurs in various ways that include billing for services that have not been delivered, unbundling, duplicate claims, unnecessary or excessive services and up coding of services or items. With the passage, of time new and more complicated ways of making fraudulent claims are emerging.

Discussion

Financial implications

Fraud accounts for 25 % of health care costs. Each person ...