Health Insurance Schemes That Caught Up With the Culprits

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Health insurance is an extremely useful type of insurance for all individuals to possess. Although it is usually used in a legal manner, there are cases cropping up now and then which revolve around health insurance fraud. There are a few more readily perpetrated health insurance related crimes which courts are seeing around the country on a more frequent basis these days.

Overbilling by Medical Health Professionals

One type of health insurance scheme which plagues our nation is the practice of overbilling by medical health professionals. In this type of scenario, doctors would charge clients for medical treatment which they never received and collect the money from the insurance companies.

Some of the instances where the individuals were charged with health insurance fraud include a chiropractor from Pennsylvania who tried to collect money from insurers for procedures and treatments never performed and a Texas physician who was convicted in federal court of billing health insurance companies for treatments never performed by him. This is a great concern to health insurance providers as they have to compensate for services never rendered.

False Claims by Insured Individuals

Another well-known type of health insurance fraud which occurs and drives up the cost of health insurance premiums is the instance of false claims by insured individuals. In this type of case, those who have health insurance will file false claims with the insurance companies for injuries never received or self-inflicted injuries in order to receive payouts from the insurance company.

One such case regarding this type of health insurance fraud is that of a New Jersey couple who falsely claimed that they were married in order to receive health insurance benefits. They were recently indicted of the fraud crime and are currently awaiting trial. If convicted, the two can each receive a maximum penalty of 16 years in prison and $175,000 in fines.

The Results of This Type of Health Insurance Fraud

The previously mentioned frauds are just two types of various health insurance schemes which have been perpetrated by both members of the medical health profession and individuals who receive health insurance benefits. The results of these types of crime are quite grave in nature. Not only does health insurance fraud have consequences for those who commit these crimes but for all insured individuals. The individuals who commit health insurance related crimes pay the price by enduring possible jail time and fines.

As for the general public who receive health insurance benefits, they are the ones who truly get hurt in the long run as they will ultimately have to pay higher health insurance premiums as a result of these individuals who commit the fraudulent acts. The good news is that state and federal authorities are aware of the persistence of these crimes and are working night and day to stop them from occurring.

References

http://www.phillyburbs.com/pb-dyn/news/112-01172008-1472951.html

http://houston.fbi.gov/dojpressrel/pressrel06/ho110606.htm

http://www.helpstopfraud.org/content/?/effects/cases&item=4956

photo credit: notsogoodphotography

This entry was posted on Friday, May 2nd, 2008 at 11:36 am and is filed under Health Insurance. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.