Healthcare Fraud

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Healthcare fraud occurs when a provider, employer group, or member tries to deceive or misrepresent a healthcare transaction in order to receive an unauthorized benefit or financial gain. The Attorney General designated healthcare fraud as the Department of Justice’s number two-enforcement priority in 1993, allowing anyone convicted of healthcare fraud to face large fines and imprisonment. When healthcare fraud occurs, it creates financial costs for the rest of the country and threatens the quality of continuing health care. It is estimated that between $30-$100 billion is lost every year because of healthcare fraud.

Healthcare fraud can include instances like kickbacks, billing for any service, procedure, or supply that was not provided, deliberately billing for application for duplicate payments of services, amongst many other fraudulent acts. There is no way to track criminal activity in the health care system to help assist federal, state, and industry anti-healthcare fraud enforcement at this time, but the FBI, US Postal Inspection Service, amongst other Offices of Inspector General are responsible for investigating healthcare fraud. If you would like to learn your legal rights and options regarding healthcare fraud, please contact us.