If you work in any area of healthcare, you know that upcoding is a kind of fraud in which the government is charged for a more expensive procedure than was actually performed.
Health care fraud is prevalent because, in this industry, there are so many ways to obtain easy cash. People involved might be employers, patients, vendors and providers, including pharmacists.
Health care fraud is a widespread issue in the United States. It is also a top priority for federal law enforcement agencies, including the FBI. These agencies devote massive resources to investigating alleged fraud through actions like undercover operations and task forces, and they want these efforts to pay off.
The Department of Health and Human Services has been vigilant in detecting possible instances of health care fraud. About a week ago, the agency announced that more than 400 individuals were charged with committing health care fraud. The alleged fraudulent billing practices from those charged exceeded $1.3 billion.
One of the harder parts of being a health care professional is caring for patients that are suffering from a terminal illness. In those instances, the patient may be referred to a hospice program.
Our health care system and government health care programs like Medicare are complex. In light of these complexities, it shouldn’t be a surprise that medical professionals are accused of abusing or defrauding Medicare from time to time.