Health care and health insurance fraud affect countless victims in California and elsewhere. There are different ways that these illegal acts can take place.
Who commits these acts of fraud?
Anyone can commit health care or health insurance fraud. Often, a doctor or other medical professional is behind the crime, but a patient can also commit them by intentionally deceiving the health care system or insurance company. For example, exaggerating on an insurance form while signing up for health insurance the person doesn’t deserve.
As a white-collar crime charged at the federal level, if an instance of health care or health insurance fraud is suspected, the Federal Bureau of Investigations will investigate along with other federal, state or local agencies. Sometimes, other parties are involved as well such as those involved with health care and insurance groups.
Ways that health care and health insurance fraud are committed
There are many ways a person can commit these types of fraud. One of the most common involves billing for services never provided. For example, a doctor performs an X-ray on a patient but bills for surgery that was never performed. Double-billing is also common and occurs when a doctor gets payment from two sources instead of one.
Kickbacks are common in healthcare fraud and occur when a doctor agrees to cut fees for some type of perk. This is a form of bribery.
Health insurance fraud often involves inflating bills for the services provided to patients. For example, a person goes to the dentist and has a single filling but is billed for multiple fillings instead.
These types of charges should be taken seriously, and a strong defense is needed to combat them.