The United States Department of Justice charged 36 defendants for healthcare fraud that amounted to over $1 Billion. The fraudulent actions included telemedicine, cancer and cardiovascular testing, and fraudulent durable medical equipment. The individuals charged ranged in positions from medical company executives to medical professionals. Many of these individuals targeted elderly patients who receive Medicare benefits.
What Happened?
One of the illegal actions investigated was the bribing of laboratories in exchange for patient referrals. Many of these referrals were for tests that were unnecessary and expensive. Often these tests would bear no useful results to the patient. Others controlled telemarketing schemes in order to target elderly Medicare patients to consent to tests by misleading and deceiving them.
What is Being Done About it?
The Centers for Medicare & Medicaid Services investigates these cases and prioritizes protecting patients. They partnered with the Department of Justice and the Department of Health and Human Services to successfully investigate and prosecute individuals who seek to take advantage of consumers. Law enforcement agencies across the country are dedicated to catching those that seek to take advantage of patients.
How to Protect Yourself?
As a consumer, it is best to be vigilant and keep an eye out for those that seek to scam you. It is also important to educate yourself on the methods that scammers use for financial gain so that you can spot these instances if they attempt to victimize you.
Healthcare organizations must take all possible steps to prevent instances of fraud. Employees should receive training that educates them on how to identify, report, and combat fraud, waste, and abuse in the workplace. This training teaches healthcare providers to create transparent work environments that promote an improved patient experience and reduce legal risks.
Get Certified
American Medical Compliance (AMC) is a leader in the industry for compliance, billing, and HR solutions. Learn more about how to protect your health organization from fraud by taking our Healthcare Fraud, Waste, and Abuse (FWA) Training 3.0 course today. Visit https://americanmedicalcompliance.com/ for more information.
Reference
United States Department of Justice (20 July 2022). Justice Department Charges Dozens for $1.2 Billion in Health Care Fraud. Retrieved from: https://www.justice.gov/opa/pr/justice-department-charges-dozens-12-billion-health-care-fraud
