Health care fraud is a key driver of rising health care costs. About 3% of all health care spending — or $68 billion each year — is lost to health care fraud. There are a few types of health care fraud including:
- Medical Identity Theft. This is the misuse of a person’s medical identity to obtain health care goods, services or funds. This can include fraudulent prescriptions, billing for services that were never provided or referring patients for unnecessary services.
- Upcoding. This is when the provider bills for a service of higher complexity than the service that was provided or documented. For example, a supplier may bill for motorized scooters, but supply manual wheelchairs.
- Billing for Services not Furnished
- Others can be found here
Here are some things you can do to help prevent health care fraud and abuse.
- Review your health care charges. Look over your Explanation of Benefits from your insurer and receipts from your doctor...