Health Care Fraud is commonly known by other names such as health insurance fraud, medical billing fraud, health insurance fraud and Medi-Cal Fraud. The complicated and confusing bureaucracy associated with the payment process has lead to authorities accusing innocent providers and beneficiaries of health care fraud. In many instances these are just the result of honest mistakes.
Common Examples of Fraudulent Conduct
Health Care Fraud is an intentional attempt by some providers, and in some cases beneficiaries, to receive unauthorized payments or benefits from the program. This fraud can take many forms, but the most common instances involve knowingly billing for services not performed, billing for more expensive services than the ones the patient actually received (known as “upcoding”), providers billing for the care of more beneficiaries than they can actually serve, and submitting a second duplicate claim for services already paid for.