Uncovering the Shocking Truth: Real Health Insurance Frauds Examples You Need to Be Aware Of
As healthcare costs continue to skyrocket, more and more people are relying on health insurance to help cover medical expenses. Unfortunately, this has led to an increase in health insurance fraud, leaving many people vulnerable and without the coverage they need. In this article, we will uncover real health insurance fraud examples that you need to be aware of to protect yourself.
What is health insurance fraud?
Before we dive into some examples, let’s first define what health insurance fraud is. According to the National Health Care Anti-Fraud Association, healthcare fraud is “an intentional deception or misrepresentation that the individual or entity makes knowing that the misrepresentation could result in some unauthorized benefit to the individual, or the entity, or to some other party.”
Health insurance fraud can take many forms, including billing for services not rendered, forging prescriptions, and offering kickbacks for referrals.
Real-life health insurance fraud examples
1. Billing for services not rendered: In 2020, a New York chiropractor was sentenced to one year in prison for billing insurance companies for services he never provided. He reportedly submitted more than $3 million in fraudulent claims.
2. Overcharging for services: In 2019, a Florida man was sentenced to over 12 years in prison for his role in a health insurance fraud scheme. The man reportedly overcharged insurance companies for prescription drugs and medical equipment, resulting in more than $12 million in losses.
3. Forging prescriptions: In 2018, a Pennsylvania doctor was sentenced to 15 years in prison for his role in a health insurance fraud scheme. The doctor reportedly forged prescriptions for opioid painkillers, resulting in more than $5 million in fraudulent claims.
How to protect yourself from health insurance fraud
Now that you are aware of some real-life health insurance fraud examples, it’s important to know how to protect yourself from falling victim to fraud.
1. Be cautious of anyone offering free tests or services in exchange for your insurance information. These offers may be fraudulent attempts to bill your insurance company.
2. Keep track of all your medical bills and statements. Review them carefully and report any suspicious charges to your insurance company.
3. Be wary of anyone offering to bill your insurance company for services not rendered. This is a common type of health insurance fraud.
Conclusion
Health insurance fraud is a serious problem that can leave people vulnerable and without the coverage they need. By being aware of real-life examples and taking steps to protect yourself, you can avoid falling victim to fraud and ensure that you have access to the healthcare you need. Remember to always review your medical bills and statements carefully, and report any suspicious charges to your insurance company.
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