Medical Fraud

The following are all considered medical fraud:

  • Forging a Certificate of Medical Necessity
  • Billing the federal government for new or expensive equipment, but giving the patient used or cheap equipment
  • Reflex testing: Running a test because of another test, without the request of a doctor
  • Charging the federal government for equipment or supplies that were not even ordered
  • Code jamming – using fake diagnostic codes to fool the federal government into paying
  • Defective testing: Not completing the test because the machine is defective, but billing anyway
  • Double billing: charging twice for one service
  • Up coding: fraudulently adding diagnostic codes to a patient’s chart to allow billing for more expensive treatments than were actually provided by the doctor or hospital
  • Unbundling: Using multiple billing codes to describe a procedure when the rules and regulations mandate that a single “bundled” billing code be used
  • Billing for tests not actually performed, sometimes referred to as “phantom billing:
  • Performing unnecessary tests to allow billing
  • Nursing home abuse: providing incompetent and substandard care to patients and billing Medicare for reimbursement

IF YOU ARE INTERESTED IN PURSUING A MEDICAL FRAUD CASE, CONTACT Hodges Trial Lawyers ONLINE OR CALL US AT (888) 539-3110 TO SET UP A FREE CONSULTATION TO DISCUSS YOUR OPTIONS.