Top 5 Biggest Health Care Frauds
Without a doubt, health care fraud is one of the biggest threats to our nation’s economy. In fiscal year 2009, Medicare, Medicaid and the Children’s Health Insurance Program cost taxpayers and the government $895.9 billion dollars. Health care fraud cost is estimated by Thomson Reuters, an industry leader, to cost approximately $150 billion per year. That is a huge percentage of health care costs which is why so much money and resources are being used to prevent it. Florida leads the way in health care fraud since it “is an obvious magnet for Medicare scammers since so many elderly Americans have retired to end their days in its famous sunshine” http://www.caring4cancer.com/go/cancer/news?NewsItemId=20110413elin006.xml. Below are five of the biggest health frauds that cost our country billions and threaten the entire health care system.
1) Dreaded Disease Policies
This scam involves an insurance provider that claims to cover major medical expenses for diseases such as cancer and heart attacks. You might be making you monthly premium payments, but once the bill comes do these sham companies are nowhere to be found. Since treatment for “dreaded diseases” are extremely expensive, this type of fraud costs the health care system billions. With proper health insurance, these special policies are not necessary so be extremely wary of any company that offers them.
2) Hospital Indemnity Policies
These scams involve phony insurers who agree to pay a set amount for in-patient hospital stays. By the time you are out of the hospital you learn this policy never covered your stay. To protect yourself you should always make sure your hospital stay is covered by your policy. Also make sure that even if your policy is legitimate that it is active during your hospital stay and that it covers your condition.
3) Faith Plans
Due to limited oversight due to first amendment rights, health care plans provided through local and national congregations have been known to scam their members. While many faith-based plans are legitimate, there are some that embezzle money from their congregation and leave them uninsured and responsible for huge medical bills. State insurance regulators are working to make faith plans more transparent but for now it is important to be extremely cautious. The best you can do is check with your state regulators.
4) Double Billing
Double and triple billing costs taxpayers billions of dollars every year. Unscrupulous health care providers will charge for the same services and treatments numerous times hoping that insurers will not notice. This unfortunately happens all the time and needs be better policed by insurance regulators.
5) Identity Theft
As technology grows, so do the risks of identity theft. While we think about identity theft in terms of our own personal turmoil, identity theft cheats the health care system out of billions of dollars. By stealing your medical ID, crooks can bill health care programs for phony treatments. Medical info can be easily obtained from hospital dumpsters and then used to bill.
There are many other health care frauds that are prevalent but these are some of the biggest frauds taxpayers and government sustain every day. They cause premiums to rise and quality of care to decrease. Understanding you medical coverage and protecting personal information is the best defense against health care fraud.
The information supplied in this article is not to be considered as medical advice and is for educational purposes only.
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 American Health Care 27 Apr 2011 |
