Feb 20, 2024 Healthcare Billing Fraud
Healthcare Billing Fraud
Medicare Healthcare Medical Billing Insurance Fraud Video
Healthcare Billing Fraud: Legal Aspects of Healthcare
The definition of healthcare fraud can occur in various forms. According to most literature, healthcare fraud encompasses the information cover-up, misrepresentation, or deceit often with the objective of gaining financial advantage. The Department of Health and Human Services in a 2016 report asserts that the crime can be committed by healthcare providers and individuals in various ways. Whereas there are laws that have been formulated to address healthcare fraud, they differ across jurisdictions. A quintessential case of healthcare fraud involves the U.S. ex rel vs Community Health Systems. In the case, the defendant (Community Health Systems) was under the accusation that they engaged in a multiplicity of fraudulent activities for purposes of increasing reimbursement rates from both Medicaid and Medicare. Specifically, the plaintiff charged that CHS defrauded the government of millions of dollars by miscoding items that fell under Medicare. Consequently, CHS committed the crime of fraudulent billing and falsified claims in contravention of 31 U.S.C $ 3729 (a) (3).
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