A Video Explaining Health Insurance Fraud

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Read the full article at https://www.linkedin.com/pulse/health-insurance-fraud-barry-zalma-esq-cfe and see the full video at https://rumble.com/vj1el1-health-insurance-fraud.html and at https://youtu.be/KNPuj-QIUO4 and at https://zalma.com/blog plus more than 3800 posts.

The nation’s bill for health care fraud is enormous  as large as $300 billion or more every year. Fraud takes place at many points in the health care system, in hospitals, nursing homes, and diagnostic facilities, by doctors, attorneys, health care providers, durable equipment providers, and patients.
One large area prone to fraud is the Medicare system. This system processes more than 800 million claims a year with 70 different contractors handling the claims that come from hundreds of thousands of doctors, laboratories, and other health practitioners and facilities.

In 2012 Medicare paid out over $817 billion dollars. If only five percent went to fraud, they took over $40 billion and if ten percent went to fraud more than $81 billion was paid to fraud perpetrators. I have heard estimates up to 30 percent of payouts are fraudulent. The numbers, regardless of the percentage, are excessive.

Surveys show that it is usually the claimant who perpetrates the fraud, as opposed to health care providers, employers, or attorneys. The most common fraudulent activity is a false statement or omission of information, i.e., lying about the severity of an injury or failing to mention a pre-existing condition then profiting by obtaining a portion of the amounts billed from the provider.