Healthcare Fraud Statute of Limitations

What are the major types of Federal Healthcare Fraud Offenses?

Healthcare fraud is a serious crime that involves the intentional deception or misrepresentation of information in order to obtain payment from government healthcare programs or private insurance companies. Some of the major types of healthcare fraud include:

  1. Billing for services or procedures that were not actually provided: This occurs when a healthcare provider submits false claims for reimbursement for services or procedures that were not actually performed.

  2. Upcoding: This occurs when a healthcare provider submits claims for reimbursement using codes for more expensive procedures or services than were actually performed.

  3. Unbundling: This occurs when a healthcare provider submits claims for reimbursement for individual components of a bundled service or procedure, rather than the bundled service or procedure itself, in order to receive higher reimbursement.

  4. Kickbacks: This occurs when a healthcare provider receives money or other benefits in exchange for referring patients to a particular facility or provider.

  5. False certification: This occurs when a healthcare provider falsely certifies that a patient is eligible for certain benefits or services.

  6. Prescription drug fraud: This occurs when a healthcare provider or pharmacist fraudulently bills for prescription drugs that were not actually dispensed or prescribed.

  7. Identity theft: This occurs when a person uses another person's personal information to bill for healthcare services or to receive healthcare benefits.

It's important to note that these are just examples, and there are many other types of healthcare fraud. Healthcare fraud is a serious crime that can result in significant fines and imprisonment. The U.S government has several laws that criminalize healthcare fraud, such as the False Claims Act and the Anti-Kickback Statute. Moreover, the U.S Department of Justice and other federal agencies work closely with state and local