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
