Medicare fraud


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Medicare fraud

A generic term for any unlawful act which results in the inappropriate billing of Medicare for services by a healthcare provider, including physicians, hospitals and affiliated providers.
 
Examples
Billing for or performance of duplicated services, claims for services not rendered, billing for services not deemed medically necessary, miscoding of medical and/or surgical procedures, excess charges for services or supplies, breech of assignment agreements, billing Medicare patients at a higher or different fee schedule, waivers of co-payments and deductibles, and other improper billing practices.

Medicare fraud

Medifraud Medical practice Any unlawful act which results in the inappropriate billing of Medicare for services by a health care provider–eg, physicians, hospitals and affiliated providers. See Medicare.
References in periodicals archive ?
The "best" include leaders and groundbreakers in psychiatry, oncology and health economics, whereas the "worst" includes those who faced criminal charges from murder to Medicare fraud.
Defendants were charged in more than 20 states, including California, Florida, Illinois, Louisiana, Michigan, and Texas, where the federal government operates Medicare Fraud Strike Forces.
Defendants were charged in more than 20 states, including Florida, Michigan, Texas, California, Illinois, and Louisiana, where the federal government operates Medicare Fraud Strike Forces.
Ms Burchill has dealt with matters including drug importations, cybercrime, Medicare fraud and cultural heritage.
Related: Medicare fraud affects home care for seniors
CHICAGO -- Diana Jocelyn Gumila, 46, faces up to 10 years in federal prison and a mandatory $250,000 fine and restitution after she was found guilty April 17 on 21 counts of Medicare fraud and three counts of making false statements pertaining health care.
Healthcare and other specialists also discuss physician Medicare fraud, continuous improvement in public reporting, what Canada can learn from the US experience in reducing healthcare-associated infections, applying the free market philosophy to healthcare, pharmaceutical supply chain management, primary care, hospice care, healthcare management, and age-based rationing.
A nationwide investigation by the federal Medicare Fraud Strike Force has led to health fraud charges against 243 people--including 46 medical providers --in the largest bust in strike force history.
Medicare fraud and strategies to combat the crimes have become more intense as the program has grown in size and complexity, experts say.
40) In addition, the Medicare Fraud Strike Forces, created in 2007, operates throughout the country to support HEAT's mission.
According to the FBI, Medicare fraud costs taxpayers $17 to $57 billion dollars per year.
There is also the story of Syed Imran Ahmed, a doctor facing Medicare fraud charges.

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