Medicaid Provider Fraud

Medicaid provider fraudWhen we get sick, the first thing that we do is ask for professional help, without even admitting that we might become victims of a Medicaid Provider Fraud. Medicaid providers, as a symbol of care and custody, usually inspire trust and confidence, making us expect that our provider will supply us nothing, but help.

Unfortunately, statistics say that Medicaid Provider Fraud is a well-spread phenomenon among scammers, which steal billions of dollars annually. Moreover, the Federal Government also counts on physicians to submit accurate and truthful claims information, by creating such programs as Medicare, Medicaid, and other health care policies. Let’s have a deeper insight into the concept of this type of fraud and analyze the possible countermeasures.

WHO CAN BE CHARGED WITH MEDICAID PROVIDER FRAUD?

First of all, every member of the health care community (individual, corporation, or other entity paid by Medicaid) can potentially become a scammer, including nurses, nurse aides, nursing homes, pharmacies, ambulance and transportation companies, chiropractors, podiatrists, licensed professional counselors, community care service providers, dentists, hospitals, medical equipment companies, speech therapists and others.

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Things You Should Know About Healthcare Programs Recipient Fraud

medicaid fraudEasy money have always been an attractive incentive for the majority of people. Some of us, are more likely to think that a little fraud will not lead to serious cases of criminal prosecution. For those who could not resist temptation – here are several things you should know about Medicaid Recipient Fraud.

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Fraud Crimes. Losses Due to Insurance Fraud. Hard Fraud vs. Soft Fraud

Insurance fraud refers to an intent to obtain some benefits or advantages by means of false andimages misleading information filled in in the insurance document and consists of exaggerated damage or losses that never occurred. According to Crime in the US 2012 FBI Report the total cost of insurance fraud is more than $40 billion per year. In 2011 there were 140 pending insurance fraud cases.

There are two types of insurance fraud:

  1. Soft fraud, that consists of “little harmless lies” in order to maximize the claim.
  2. Hard fraud, that involves falsification of an accident or an injury in order to legally collect money from the insurance agencies.

arson-300x225There are common types of insurance fraud that include: exaggerated injuries, false or exaggerated property loss, car accidents, intentional property damage, arson.

If you don’t want to become a victim of insurance fraud, don’t trust people who sell insurance over the telephone or door-to-door. It is also not wise to give your insurance ID number to people or companies you don’t know. Don’t forget, if an accident occurred to you, make sure you get as much evidence as possible.

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Legal Cartoon

Compliments of Mark Anderson of Andertoons

Corporate Fraud – How Corporations And Big Companies Lie About Their Financial Condition

frCorporate fraud refers to large organizations that deceive their investors, analysts and auditors about the real financial condition of a corporation. Corporate fraud results not only in financial losses of the investors, but also creates great potential damage to the U.S. economy.

Such fraud may be accomplished through:

  • manipulation of share prices
  • control of financial datafraud
  • artificially inflated financial performance
  • false indicators
  • different valuation measurements

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Health Care Fraud Costs U.S. $80 Billion A Year. How Much Does Health Care Fraud Cost You?

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According to the FBI, Health Care fraud costs U.S. $80 billion a year. Health Care fraud is a crime that involves the filling of a deceitful health care claims in order to receive a profit. Health Care Fraud covers such types of fraud as:

  • General Insurance Fraud001
  • Medicare Fraud
  • Medicaid Fraud
  • Prescription Drug Fraud
  • Medical Identity Theft

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Medical Identity Theft: What Are The Reasons For This Fraud Crime? What Are Your Risks?

Medical identity theft is one of the fraud crimes that has increased over the past years in the United States. According to the Ponemon Institute 1.84 million people were victims of medical identity theft in 2013 with an estimated total cost of $28,6 billion.

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It is illegal to use a person’s identity or personal health information to receive health care services. Some people intentionally commit fraud against “themselves” by allowing uninsured people to use their health insurance to obtain care. This is called “Robin Hood” crimes and it constituted 30% of medical ID theft in 2013.

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There are different reasons for stealing someone else’s medical identity:

  • obtain prescription drugs to sell them
  • get free treatment
  • falsify or inflate treatment claims

 

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Auto Insurance Fraud Costs Americans $20 to $30 Billion Annually

Auto insurance fraud is becoming a great problem in the United States. Auto insurance agencies are paying billions of dollars each year to cover them, that leads to increased premiums even for those who didn’t commit fraud.

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Auto insurance fraud is committed against an insurance company in order to receive financial gain. According to the National Insurance Crime Prevention bureau auto insurance fraud costs Americans $20 to $30 billion annually.

insuranceAuto insurance fraud can be “hard” if it consists of an intentional set up of a situation such as car theft or an automobile accident. Soft insurance fraud is regarded as a minor offense, when a person takes advantage of a situation that has already occurred by pretending that the injuries were more serious that they actually were.

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