Fraud happens more than we care to think about. It happens in insurance. It happens in banking and finance. It happens regularly in any industry that requires the honest handling of money and services. Medical fraud, however, seems to hurt more people – oftentimes in the literal sense. There have been many reported cases of patient neglect or death resulting from fraudulent practices.
But what is truly scary is that most cases of fraud are instigated, supported, or practiced by medical professionals themselves. They do this in spite of being in a position where people entrust their lives and health to them.
Cost of Medical Fraud
Medicaid Fraud is also costing the United States tens of billions of dollars annually. With national health care expenditures going beyond trillions of dollars in recent years, it seems everyone wants to line their pockets with more than they should be earning. Why does this happen and keep happening? Why do white-collar criminals exist in our health care institutions?
A lot of people tend to think that fraud always occurs on a grand scale, with shifty-eyed perpetrators exposed on camera, and a paper trail of carelessly-spent ill-gotten gains traced back to them. This is not true at all times. Fraud can occur in seemingly “acceptable” or negligible circumstances: reimbursement for activities or items not related to health care, accepting “gifts” from service providers in exchange for patient referrals, and so on and so forth. There seems to be an unspoken rule regarding fraud: if my colleague does it, why shouldn’t I? Fraud is rarely the work of one person; there is almost always a conspiracy between two or more people to accomplish it. Most of the time, we only become aware of fraud when it becomes a habit that gets overlooked and causes a serious flaw in the system.
Medical Fraud Infographic
An infographic released by Streamline Verify illustrates seven of the most widely practiced acts of medical fraud committed in recent times. Examples include falsifying statements regarding health care matters, grand larceny, and accepting kickbacks. In recent fiscal years, the Office of the Inspector General (OIG) has reported almost 1,000 cases of fraud in their exclusion list, numbers that have alarmingly remained consistent in the past five years!
Medical fraud exposes the kind of criminals in our health care system that should be doing their best to help us have healthy lives instead. If left unchecked, these white-collar criminals can end up killing the healthcare industry –and us– with their greed.