Fraud in Healthcare

Healthcare fraud is considered a white-collar crime. It happens every day, in every healthcare system. This type of fraud is very frequent and hard to identify. It costs Americans over fifty-four billion dollars a year. Medical providers, policyholders and pharmacies are capable and guilty of committing this lucrative crime. Every one has felt the affects of healthcare fraud because it continues to increase the cost of healthcare. (Brickey, 2006).

Fraud in healthcare can come in numerous forms such as: practitioners ordering unneeded prescriptions to sell on the black market; charging patients for services that were never performed; changing medical records and purposely miss-reporting diagnosis to increase one’s payment; and etc. One of the most notable scams was the Russian Rolling Lab. This scam involved a RV that would pull up to various shopping malls and encourage people to get free cholesterol and blood sugar tests.

The people would receive these services for free, as long as they gave the testers their insurance information. Later the scammers would bill their insurer for numerous tests that were never performed. The payments were sent to a fake address. These scammers got away with billions of dollars before they were caught. (Langlois, 1997). Healthcare fraud jeopardizes the overall healthcare for consumers.

As many scammers continue to get away with this type of crime, healthcare costs continue to rise. This rise in cost hits consumers hard in their wallets. Healthcare is necessity that consumers will continue to pay to protect their future. The increasing price of healthcare is a necessary evil that keeps attracting scammers; but also maintains a sense of security with consumers. To protect oneself from healthcare fraud; ask questions about the services you are going to receive.

Ask for the reason you need those specific services and for the cost. One should also question advertisements and promotions that offer free services (especially when a copy of your insurance card is requested). Last but not least, always be careful about disclosing one’s insurance information; protect your healthcare card.

References Brickey, K. (2006). Corporate & White Collar Crime, Aspen Publishers Langlois, D. (1997). Healthcare Fraud Sweeps the U. S. November

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