HEALTHCARE FRAUD

Healthcare Fraud (often charged under federal law) refers to any illegal activity involving medical fraud, prescription fraud, and fraud against and insurance carrier or government healthcare program.  Individuals charged with Healthcare Fraud may but need not be licensed professionals or healthcare workers.  The following are common examples of Healthcare Fraud:

 

  • Up-coding insurance claims

  • Ghost patients

  • Services not provided

  • Services not medically necessary

  • Fraudulent prescribing of compound medication

  • Kickback payments

  • "Incident to" violations

  • Unqualified or unlicensed providers

  • Unlawful prescribing of pharmaceuticals and/or steroids

  • Black market pharmaceutical sales (illicit sales of pharmaceuticals)

  • Fraudulent claims to recover insurance or government or benefits

  • Medicare/Medi-Cal Fraud