Health care coverage is a concern for people throughout Tennessee. With medical expenses for illnesses, conditions and injuries often rising in rapid fashion, having insurance is essential. In some instances, however, people are accused of committing fraud either when...
Health Insurance & Medicare Fraud
Medicare fraud case transferred to federal district court
In the legal sense, the term “fraud” connotes deceit and an underhanded act or scheme. When applied to specific areas of law, the elements change but reflect the general principle. In cases of Medicare fraud, a federal statute entitled the False Claims Act (FCA)...
What does health care fraud look like, and who can be charged?
According to the FBI, health care fraud costs American taxpayers tens of billions of dollars every year. It can lead to higher taxes, higher costs for health care and insurance, and even expose people to unnecessary medical treatments. Because the costs are so high...
Understanding fraud in the health insurance arena
Access to medical care is a critical component of maintaining one’s health. When a Tennessee resident has a medical problem, they may contact their doctor and schedule an appointment to have their ailment assessed, diagnosed, and treated. Once the patient’s care is...
Workers’ compensation fraud: What is it?
It’s no picnic trying to run a business these days -- and it’s not easy being an employee in a lot of places, either. Just don’t try to skirt the rules surrounding workers’ compensation. Whether you’re a business owner, a medical professional who treats workers’ comp...
Don’t exaggerate your claim, or you could be accused of fraud
You know that faking an injury is a kind of fraud if you end up making an insurance claim for it, but did you know that just exaggerating your injuries could be fraud, too? It is a crime to defraud the insurance agency by falsely representing the facts of your case....
Accused of Medicare fraud? You need to protect yourself
If you’ve been accused of Medicare fraud, you need to know that it’s extremely serious. It is essentially stealing from the government, and that can lead to heavy fines and penalties as well as a prison sentence. Today, the Medicare Fraud Strike Force is in charge of...
If you unbundle medical charges, that might be billing fraud
Both private insurance companies and federal insurance programs negotiate repayment schedules with medical providers such as hospitals and physician's offices to control costs. Agreeing to certain costs and terms are what make your practice an in-network care provider...
How can you avoid Medicare fraud charges?
Both Tennessee and federal officials are serious about cutting down on health insurance and Medicare fraud. This is one of the reasons why they urge consumers to be on the lookout for health care scams. There are certain steps that you should take as a medical...
Health care fraud and the Anti-Kickback Statute
As a medical professional, such as a doctor or nurse, you're familiar with what you are and are not permitted to do in regard to how you treat patients. However, when it comes to billing standards, such as how to bill an insurance company or Medicare, you may not have...