Common types of health care and health insurance fraud

| Apr 16, 2021 | Fraud

Health care professionals and other individuals can be charged with health care fraud in California. This white-collar crime is treated seriously: People who are convicted of health care fraud might face substantial fines and be sentenced to serve years in prison. Medical professionals who commit health care fraud might also lose their medical licenses. There are many ways that health care fraud can be committed, and some of the most common types are discussed below.

Common types of health care fraud committed by medical professionals

Medical providers sometimes commit fraud against the government through fraudulent billing practices involving Medicaid or Medicare. Providers submit claims using specific codes. Some practitioners submit several claims for the same service in a practice known as double billing. Others unbundle services that are supposed to be submitted under a single code into separate services to get more money. Medical professionals might also bill for services that were never provided or bill for a costlier treatment than was provided to a patient.

Common types of health care and health insurance fraud committed by patients

Individuals can also commit health care or health insurance fraud in several ways. A patient might try to trick someone else into providing their health insurance identification information to steal their identities, bill for services that were not provided or enroll them in false benefits plans. Individuals might also pose as health care professionals to provide and bill for services without being licensed. Some people forge prescriptions or visit multiple doctors to get several prescriptions, which also counts as fraud.

People who are indicted for health care fraud might want to retain an experienced white-collar crimes defense lawyer as soon as possible. These types of charges might result in a lengthy prison sentence, restitution, hefty fines and the loss of a medical license.