| Medical Scams
In 2008, Medicaid fraud units collected more than $1.3 billion in
restitution, fines, penalties and settlements, according to an
annual report issued last month by the HHS inspector general's
office. The Medicaid fraud units, most of which are housed in each
state's attorney general's office, also led to 1,314 convictions and
the exclusion of 755 providers from participating in Medicare or
other federal health programs.
Medical Scams may include the following:
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Billing for
services not rendered or not medically needed. |
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“Up Coding” -
billing for a higher medical diagnosis or more services that are
more lucrative. |
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Kickbacks –
receiving and giving money, assets or services for patients. |
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Physicians who
financially benefit by working with outpatient providers, such
as home health agencies, durable medical equipment firms and
rehabilitation providers and others, to improperly approve
medical services. |
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Recruiters who
go door-to-door to solicit Medicare beneficiary numbers to sell
to health care providers. |
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