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:http://www.warrenbensonlaw.com/medicare-fraud.jsp
  • 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:http://www.medicare.gov/FraudAbuse/Overview.asp
  • 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.


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