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The basics of Medicare fraud in Louisiana

Some criminal offenses are prosecuted in state courts while others are considered more serious and are prosecuted in federal courts. Most Calcasieu Parish, Louisiana, readers understand that federal crimes are more serious than state-level misdemeanors. Federal criminal offenses may carry more lengthy prison sentences, large fines and other penalties. One type of fraud that can make headlines is Medicare fraud - but what exactly does that mean?

People with disabilities and people aged 65 and above are entitled to health care services through Medicare, a federal health insurance program. Health care services that are covered by Medicare are indicated on the claim form, which is submitted by the health care provider. Medicare then issues a reimbursement. Federal health care fraud may arise in cases where a health care provider has filed false statements for financial gain. Medicare fraud cases can cost billions of taxpayer dollars, which is why the federal government encourages the public to report possible cases of health care fraud.

Some of the most common forms of Medicare fraud are:

  • Billing for supplies or services that were not provided
  • Billing for Medicare appointments that did not occur
  • Alteration of claims or receipts with the intention to receive a higher reimbursement

The federal government considers it a serious crime to file a false claim. Health care providers are often closely scrutinized, especially when there are reports pertaining to billed services that did not took place. A conviction on a federal health care fraud charge can lead to serious consequences such as license suspension and civil liabilities. A person who has committed health care fraud can also be charged if the person provides in-home services to another person and the federal government finds discrepancies in the person's claim.

Source: Cms.gov, "Medicare fraud & abuse: prevention, detection, and reporting," accessed on July 28, 2014

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