What are the Common Types of Medicare Fraud and Abuse?
Medicare fraud is one of the biggest crimes in America. Each year, it costs approximately $60 billion to taxpayers. Medicare frauds are related to health care frauds. It is about making false claims to insurance or healthcare agencies to obtain a Federal health care payment for which no entitlement would otherwise exist. Some of the most common examples of Medicare Fraud are: Phantom Billing – It’s about billing tests or services for employees who don’t exist Double Billing – Double billing means charging twice for the same service Pharmaceutical fraud – It’s making use of off-label marketing, kickbacks, price-fixing, and other schemes to increase profits from Medicare payments Lack of Medical Necessity – It includes billing for services or procedures that are not medically necessary Upcoding and Unbundling – inflating bills by using Current Procedural Terminology ("CPT") billing codes or using two or more CPT codes wh...