A new enforcement unit within the U.S. Justice Department in Chicago has been formed to fight health care fraud. The new Health Care Fraud Unit was announced around the same time as the announcement of the major $1.2 billion prosecution for a massive health care fraud scheme.
The goal of the unit is to seek out and prosecute the individuals and businesses that engage in all types of health care fraud. Acting U.S. Attorney Joel R. Levin, when announcing the new unit, explained that "Every year, health care fraud causes millions of dollars in losses to Medicare and private insurers" and that "Health care fraud also often exploits patients through unnecessary or unsafe medical procedures."
Health Care Fraud Increases Costs
Health care fraud is a significant drain on public resources such as Medicare, as well as on private insurers. Essentially, fraudulent claims that get paid out raise the costs of insurance and misuse public resources, forcing higher premiums and higher taxes upon the public.
The Department of Justice has recently been focusing on investigating and prosecuting health care fraud cases involving phony billing schemes, kickbacks, bribes, prescription fraud, and more. Prosecutions have gone after not just the businesses, but also those individually involved, and those who benefit from, the fraudulent activity as well.
Patients at Risk
One of the most common health care crimes that actually directly impacts consumers involves prescribing unnecessary medications and tests. While it may not seem fraudulent to use all the fancy technology that doctors have available to them, there are significant costs associated with doing so, as well as significant revenue and profits that medical providers can make.
Though most tests won't actually put a patient at risk, some could. Unfortunately, short of directly asking you to lie, or sign for tests that aren't happening, there may not be "tell-tale" signs that your doctor is engaging in fraudulent practices. If you suspect something is amiss with your doctor, you can always get a second opinion, or visit another medical provider, or even file a complaint with the DOJ.