AJ Lau

8 months ago ·

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Common Examples of Medicare, Medicaid
Fraud

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Medicare, Medicaid Fraud Examples and Steps to
Ensure You Don’t Commit It

eo A medical doctor invoiced his patient's Medicare insurance for both the services he
actually delivered and for services that were not delivered. He fabricated his patient's
medical records to indicate office visits and treatments that never took place.

e A gerontologist obtained the outcomes of medical testing executed by a diagnostic
firm for her interpretation of the results. She billed the patient's Medicare insurance as
if she performed both the testing and interpretation of the tests.

e A family physician worked at a medical center where low-income and needy patients
were enlisted to submit to needless exams. While he consulted with few patients,
medical records were forged by a physician’s assistant to support the billing of
Medicaid for medical procedures never performed.

e Patients with Alzheimer’s disease were sitting unsupervised inside a small room of a
medical psychological care facility watching the movie “Forrest Gump” for the
umpteenth time. Granted, it’s a great movie, but each time the patients sat in front of
the tube watching it, the facility submitted insurance claims to Medicare for providing
“group therapy.”

*These are examples of fraud as it relates to Medicare and Medicaid

Medical fraud is the intentional deception or misrepresentation of healthcare transactions by
the provider for the sake of receiving unauthorized benefits or financial gain. Healthcare
fraud is committed when a dishonest provider intentionally submits, or causes someone else to

Common Examples of Medicare, Medicaid Fraud.pdf

Common Examples of Medicare, Medicaid Fraud. Medicare, Medicaid Fraud Examples and Steps to Ensure You Don’t Commit It ●. ●. ●. ●. A medical doctor invoiced his patient’s Medicare insurance for both the services he actually delivered and for services that were not delivered. He fabricated his patien ...

https://www.docdroid.net/ROAFYdy/common-examples-of-medicare-medicaid-fraud-pdf

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