In today’s complex health care landscape, fraud is an issue that touches many lives and can have serious consequences. For those facing charges related to health care fraud, understanding the intricacies of these crimes is crucial.
This blog delves into the common types of health care fraud, providing valuable insights into how these practices occur. By shedding light on these activities, those accused of fraud can get information that may help them address the legal challenges they may encounter.
Fraud committed by health care providers
Some health care fraud cases involve medical providers themselves. They might engage in practices such as double billing, where they charge multiple times for the same service.
Phantom billing occurs when providers bill for services or supplies a patient never received, similar to being charged for a hotel stay you never booked. Meanwhile, unbundling involves submitting multiple bills for the same service, which should have been bundled into one.
Upcoding is another common health care fraud charge. It involves billing patients for a more expensive service than what doctors provided.
Prescription fraud
Forgery is one of the most common types of prescription fraud. It involves creating or using fake prescriptions to obtain medication.
Diversion refers to redirecting legal prescriptions for illegal purposes, such as selling your medication. Doctor shopping is when individuals visit multiple doctors to get prescriptions for controlled substances or find providers who engage in unethical practices.
Other types of fraud
Patients and other individuals outside of the health care sector can also commit health care fraud. For example, bogus marketing involves tricking people into giving their health insurance info for services they never receive.
Meanwhile, identity theft occurs when someone uses another person’s health insurance or lets someone use theirs. Perpetrators may also impersonate a health care professional to provide medical services without a license.
Understanding the various types of health care fraud is essential, especially for those facing charges. Knowing the specifics may help their legal teams build a strong defense.
