Essay On Health Care Fraud

Introduction: The healthcare domain has become an easy target for those who seek easy money by using fraudulent methods. The healthcare field continues to struggle as there is a rising concern among the health underwriters about the ever-increasing incidence of abuse and fraud in the medical field. Health care fraud is an opportunistic crime. The main purpose of the health care fraud and abuse is financial gain. After tax evasion, health care fraud is recognized as the leading financial crime. To meet the expanding health care fraud, this paper will help you to recognize the scope of fraud and abuse and will bring about some suggestions to combat this white collar crime.
What is healthcare fraud ?

However , it is a matter of concern that the term “insurance fraud “ is not defined under The Indian penal Code (IPC) , The Indian Insurance Act & Indian Contract Act and also under any specific laws.

Types

with which the referring physician has a financial relationship.” This might involve a kickback scheme if the referred-to party pays a commission back to the physician, but other financial relationships are conceivable. For example, many physician groups and hospitals are sustaining through growing. While some economies of scale are achievable through growth, referrals within the same financial organization are becoming normal and accepted practices that typically elude significant audit scrutiny.
3.Doctor shopping

If feigning pain or bribing a doctor does not work, a drug-seeking person may simply look for another doctor who will provide the desired prescriptions. A patient can easily visit multiple doctors to obtain prescriptions (often multiple times). Carlson refers to a study by the US Government Accountability Office that found that in 2011 about 600 patients in the Medicare program filled prescriptions from more than 20 doctors each.
4.Identity