Medicare Fraud
From Wikipedia, the free encyclopedia
Medicare fraud is a general term that refers to an individual or corporation that seeks to collect Medicare health care reimbursement under false pretenses. Common forms of Medicare fraud include:
- 1) Services not rendered
- 2) Upcoding schemes and Unbundling
- 3) Kickbacks and Self Referrals
- 4) Falsely Certifying and Giving False Information
- 5) Lack of medical necessity
- 6) Fraudulent Cost Reports
Those responsible for reporting Medicare fraud include:[1]
- 1) The Centers for Medicare & Medicaid Services (CMS)
- 2) People with Medicare
- 3) Providers of Medicare services including physicians, providers, and suppliers
- 4) State and Federal Agencies such as, the Department of Health and Human Services Office of the Inspector General, the Federal Bureau of Investigation (FBI), and the Department of Justice.
