Cases of healthcare fraud — including falsification of billing documents and claims for Medicare reimbursement for medical services — are likely to increase as demand for health services grows in the future, a Federal Bureau of Investigation report warns. Healthcare professionals need to be vigilant and should report suspicious billing document activity to law enforcement.
Fraudulent billings to healthcare programs are estimated to make up between three and 10 percent of the nation’s total healthcare expenditures, according to the FBI’s Financial Crimes Report for 2010-2011. Examples of common schemes documented in the report included:
- Billing for services never provided to patients
- Charging more for services than necessary
- Billing for unnecessary services provided for patients
- Filing of duplicate claims for reimbursement of a single service or item provided to a patient
Healthcare professionals who suspect fraud activity or encounter suspicious billing documents in the workplace can contact their local FBI office or Department of Health and Human Services office.