Health care fraud is a crime that can seriously impact individuals, businesses and organizations. It may lead to increased health insurance premiums, higher taxes and unnecessary medical procedures for patients.
State and federal agencies work together to penalize health care providers guilty of this offense. Those facing fraud charges may face prison time, pay fines and lose their licenses.
Different types of health care fraud
Upcoding, double billing and phantom billing are common types of health care billing fraud. Upcoding involves submitting codes to insurers for more expensive diagnoses or procedures than the physician actually performed.
Meanwhile, double billing involves sending multiple claims for the same service, resulting in higher fees for patients and their insurers. On the other hand, phantom billing occurs when a health care provider charges for services or procedures a patient did not receive.
Prescription fraud is another type of health care misconduct that may lead to a revoked license. Pharmacists and doctors are in a unique position to unlawfully acquire and misuse prescription drugs. They may steal drugs while working, take prescription pads, or even make prescriptions for friends.
Protecting your medical license
In California, doctors facing billing fraud accusations may be prohibited from continuing their practice. Ensuring accurate billing and following standard prescription practices should be a priority for those who want to protect their license.
Unfortunately, the health care system can be frustrating for those facing immense pressure at work and working long hours, making it challenging to avoid mistakes. If you are concerned about a potential health care fraud charge, consider working with a lawyer who may help protect your medical license and reputation.