Medicare Health Care Insurance – How to Spot a Fraud?
Medicare fraud is a form of insurance fraud, which is any type of illegitimate claim to receive health benefits for personal gain. It can take many forms. Moreover when a company intentionally misrepresents or exaggerates their medical condition, treatment, or services in order to receive payment from Medicare that they are not entitled to.
Examples include billing for services that were not provided, upcoding (billing for more expensive services than were actually provided), and kickbacks (paying or receiving money in exchange for referring patients to a particular provider).
Medicare fraud can be charging for additional or more expensive services than the patient actually received, charging for missed appointments, increasing patient sales on unnecessary services to fill bills, or paying for Medicare patient referrals.
Penalties for Medicare Fraud
Medicare fraud is illegal and considered a felony, a federal crime, and can result in fines, prison time, and exclusion from the Medicare program.
Anyone committing it could face criminal, civil, or administrative consequences, including jail time, fines, or penalties – such as loss of medical licenses or exclusion from participation in any federal health programs. Medicare frauds operated in different countries.
Medicare Fraud in the US
In 2011, a US government program called Medicare, have been charged with fraud. The company used to bill the US government for services that “were given” to people that were dead.
91 businessmen and entrepreneurs, including nurses and doctors, were charged over $295 million US dollars of health insurance fraud. The arrests took place in 8 different US cities and occurred for 3 weeks.
In April 2022, just 2 months ago, 21 people were accused of fraud in 150 Million USD worth of missing government money
during the time Covid-19 occurred. According to the Daily Mail, arrests were made in nine districts across the United States.
Misleading information – How to Beware of It
With all being said above, we really hope that such frauds will be taken care of by governments and law firms.
Before agreeing to anything, it’s important to perform good research about companies that offer health insurance and other services. Especially if you are a foreigner or a digital nomad traveling the world.
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