Medicare frauds are known as practices of obtaining unfair high pay-outs from funded and insured health care programs. This can cost millions of dollars to the healthcare program causing Medicare Abuse and Waste. This, in turn, can also cause an excessive financial burden on the Medicare Company and on your medical policy. It is therefore important that you report suspicious behavior to avoid Medicare Frauds.
The circumstances at which these frauds are committed are as follows:
- Intentionally submitting false claims, excess charges, wrong billing or unwanted documents to get big payments that you are not eligible for.
- Knowingly receiving and offering large sums of money in order to get referred to or to obtain rewards from health care programs
- Illegal referring for certain health services
Types of Medicare Fraud
The most common type of Medicare abuse occurs when the physician or hospital makes false clinics on the patient’s behalf. If you visit a clinic and you pay using your Medicare card, they tell you that a certain amount is due and charge the company for services that you haven’t availed. In this process, the clinic or hospital gets an extra amount. Another kind of Medicare fraud is when medical service provider bills Medicare for equipment or tests that a beneficiary has never received.
The last most common form of Medicare Fraud is when a wrongdoer steals the Medicare card of another individual in order to purchase medical services. This category of people can also return the equipment and pocket the money but might continue to bill Medicare. The theft of the card might happen to people
Types of Medicare Fraud Laws
Federal False Claims Act (FCA) – Penalties for false claims can be fined up to three times of claimed amount and $21,563.
Anti-Kickback Statute (AKS)- Anti referral act that makes receiving any remuneration directly illegal. The penalty for this is 73,588 and up to three times of the kickback amount.
Physician Self-Referral Law-Physicians law which penalizes them if they self-refer the patient to avail a service from one of his entities. Fine for the same is $23,863.
Tips to Avoid Medicare Frauds
- Do not provide anyone with your Medicare card or policy number who tries to lure you into receiving free gifts.
- Stay away from clinics providing you with any sort of free consultation or service.
- Beware of medical services who offer schemes with a large number of tests for a meager amount from your pocket.
- Do not believe someone who promises to get Medicare pay for something that is not covered.
- Do not handover your Medicare card to anybody except for clinics and hospitals.
- It is better to check the original bill amount before you sign for it.
- Report any suspicious fraudulent activities to your Medicare Company.
If you are being accused of Medicare fraud make an appointment today for further legal assistance.
Roy J. Kahn, with years of legal experience in a wide variety of criminal law, heads a “boutique” firm, which means that your attorney is Roy J.Kahn, not a paralegal. If you have been charged or are about to be charged with a crime—or if you have been contacted to be a witness in a federal grand jury case, you need a qualified defense. You should consult with an attorney immediately and know that you have a right to make no statement until you have consulted with an attorney To contact Mr. Kahn, he can be reached at 305-358-7400.
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