health care fraud


Also found in: Acronyms.

health care fraud

Deceptive, dishonest, and unlawful misrepresentations to a health insurer (such as Medicare) made by a provider or a patient in order to obtain money or services to which one is not entitled.
References in periodicals archive ?
An investigation began after a tip was received to the Health Care Fraud Hotline.
Mattson, of Lake Forest, initially faced 19 counts of health care fraud.
Acosta testified in 2011 at a House Energy and Commerce oversight subcommittee hearing that, in 2008, his district accounted for 32 percent of the country's health care fraud investigations.
The department also opened 782 new civil health care fraud investigations under the FCA and had 957 civil health care fraud matters pending at the end of 2014.
On January 18, 2011, Adegboye and Rufai were indicted on six counts, and later convicted on five counts, of aiding and abetting a health care fraud.
The auditors also said it's difficult to estimate a health care fraud baseline--a measure of the extent of fraud--that is needed to be able to track whether the amount of fraud has changed over time as a result of HCFAC and other anti-fraud initiatives.
This is the highest three-year average return on investment in the 16-year history of the Health Care Fraud and Abuse Program, according to yesterday's announcement.
GlaxoSmithKline has agreed to pay $3 billion US in criminal and civil fines and plead guilty to misdemeanor criminal charges related to the sale and marketing of its antidepressants and a diabetes drug in the largest health care fraud settlement in US history.
Also early in the month, at a Chicago summit highlighting a new high-tech war against health care fraud, Sebelius and Attorney General Eric Holder discussed how the law and the administration's Health Care Fraud Prevention and Enforcement Action Team (HEAT) are helping fight Medicare fraud.
A team of seven Texans led by a Dallas-area doctor were indicted today for allegedly conspiring to commit nearly $375 million in health care fraud, the Centers for Medicare and Medicaid announced.
Health care fraud is estimated to cost taxpayers $60 billion a year.
Phantom billing, fake prescriptions, and the high cost of medicine; health care fraud and what to do about it.

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