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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Michigan Oncologist Dr. Farid Fata – Medicare Fraud, Villian or Cancer Patient Savior?

 On August 6, 2013, a Criminal Complaint was filed against Michigan Oncologist Dr. Farid Fata in Federal Court in the county of Oakland in the Eastern District of Michigan.  The Defendant was charged by the U.S. Government with Healthcare Fraud in violation of 18 U.S.C. 1347.

In an affidavit in support of the Complaint, Special Agent Brian Fairweather who was employed by the Federal Bureau of Investigation (“FBI”) alleges the following violations:

  • Healthcare Fraud – 18 U.S.C. 1347
  • Distribution of Controlled Substances – 21 U.S.C. 841(a)(1)
  • Money Laundering – 18 U.S.C. 1956 and 18 U.S.C. 1957
  • Payment or receipt of Healthcare Kickbacks – 42 U.S.C. 1320a-7(b)(1)(A) and 42 U.S.C. 1320a-7(b)(2)(A)

More specifically, the Complaint alleges the following:

  • Administration of unnecessary chemotherapy to patients in remission
  • Deliberate misdiagnosis of patients having cancer to justify unnecessary cancer treatment
  • Administration of chemotherapy to end-of-life patients who will not benefit from the treatment
  • Deliberate misdiagnosis of patients with cancer to justify expensive testing
  • Fabrication of other diagnoses such as anemia and fatigue to justify unnecessary hematology treatments
  • Distribution of controlled substances to patients without medical necessity

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