How to Commit Medicare Fraud
A How to Manual to Commit Medicare Fraud
“Biggest Medicare Fraud in History Busted.” “Dallas Doctor Arrested for Alleged Role in Nearly $375 Million Health Care Fraud Scheme.” These are headlines from www.abcnews.com and a press release from the US Department of Health and Social Services from February 28, 2012. The press release continues, “The FBI views health care fraud as a severe crime problem. It causes increased costs for consumers, tax payers and health insurance plans, and degrades the integrity of our health care system and legitimate patient care. Today’s arrests send a clear message to those persons who are not only defrauding our federal Medicare and Medicaid and private health insurance programs, but victimizing the elderly and the disadvantaged. The FBI will continue to dedicate a substantial amount of expert resources to investigate these crimes.” Health care fraud, specifically Medicare and Medicare fraud, is becoming big business. Medicare fraud is a general term that refers to an individual or corporation that seeks to collect Medicare health care reimbursement under false pretenses. There are many different types of Medicare fraud, all of which have the same goal: to collect money from the Medicare program illegitimately. Medicare fraud is generally easy to do because it was originally set up as an “honor system” of billing. The United States government wanted to help honest doctors who helped the needy with medical services. There are not a lot of safeguards or internal controls in place to detect false claims. Most claims are paid automatically because the goal of Medicare was to pay claims quickly. Organized crime and gangs are starting to specialize in this type of fraud as it is much easier than selling drugs and if they are eventually caught the punishments are treated more like white collar criminals than drug dealers.
The headlines that started this paper were about a Dallas doctor and his cronies who were able to
“Biggest Medicare Fraud in History Busted.” “Dallas Doctor Arrested for Alleged Role in Nearly $375 Million Health Care Fraud Scheme.” These are headlines from www.abcnews.com and a press release from the US Department of Health and Social Services from February 28, 2012. The press release continues, “The FBI views health care fraud as a severe crime problem. It causes increased costs for consumers, tax payers and health insurance plans, and degrades the integrity of our health care system and legitimate patient care. Today’s arrests send a clear message to those persons who are not only defrauding our federal Medicare and Medicaid and private health insurance programs, but victimizing the elderly and the disadvantaged. The FBI will continue to dedicate a substantial amount of expert resources to investigate these crimes.” Health care fraud, specifically Medicare and Medicare fraud, is becoming big business. Medicare fraud is a general term that refers to an individual or corporation that seeks to collect Medicare health care reimbursement under false pretenses. There are many different types of Medicare fraud, all of which have the same goal: to collect money from the Medicare program illegitimately. Medicare fraud is generally easy to do because it was originally set up as an “honor system” of billing. The United States government wanted to help honest doctors who helped the needy with medical services. There are not a lot of safeguards or internal controls in place to detect false claims. Most claims are paid automatically because the goal of Medicare was to pay claims quickly. Organized crime and gangs are starting to specialize in this type of fraud as it is much easier than selling drugs and if they are eventually caught the punishments are treated more like white collar criminals than drug dealers.
The headlines that started this paper were about a Dallas doctor and his cronies who were able to
References: http://abcnews.go.com/Blotter/biggest-medicare-fraud-history-busted-feds/story?id=15809129#.T06NPvEgc-A http://www.hhs.gov/news/press/2012pres/02/20120228d.html http://spectator.org/archives/2012/02/02/the-fraud-in-our-entitlement-s https://www.cms.gov/medicareprovidersupenroll/02_enrollmentapplications.asp https://www.cms.gov/MLNProducts/downloads/Fraud_and_Abuse.pdf http://www.fastcompany.com/magazine/161/how-to-commit-medicare-fraud-in-six-easy-steps http://en.wikipedia.org/wiki/Medicare_fraud http://www.straightdope.com/columns/read/2836/how-would-i-go-about-laundering-money