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How does healthcare fraud take place?


Fraud in the healthcare industry costs the country billions of dollars a year. It is taken very seriously by the authorities and carries harsh penalties to deter others from going down the same path. As the prevalence of a crime rises, the investigations into it also increase and the penalties become harsher to deter others from committing the same crime. Healthcare fraud is one of those crimes, as the Federal Bureau of Investigation is tasked with investigating alleged schemes, whether the insurance program is federal or private.

There has been a lot of mention about healthcare fraud on the Atlanta Federal Criminal Defense Blog and how it impacts the accused's personal and professional life, but Atlanta residents may not be clear about what it is and how it takes place.

Medical Equipment Fraud takes place when equipment manufacturers offer free products to people, but then charge insurers for them. In these instances, often the equipment was unneeded or even undelivered. When people are given unnecessary tests, or even fake tests, at their retirement homes or healthcare centers and Medicare is charged for the test, this is commonly known as a Rolling Lab Scheme.

Medicare fraud is generally in the forms described above and typically senior citizens give their Medicare numbers in exchange for free equipment.

Doctors generally have their patient's best interests in mind and often times charges are brought against unsuspecting people whose businesses operate on a model that has been misunderstood by the government.

Since Medicare fraud and healthcare fraud in general is taken seriously by the authorities, an accusation and a conviction can have life changing consequences for those accused of the crime. Understanding the crime one is accused of is just the first step in taking the necessary steps to protect one's legal rights.

Source:, Common Fraud Schemes, Dec. 2, 2014

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