Legal Definitions - health care fraud

Health care fraud is a type of crime where people file dishonest health care claims to make money. There are many different ways that people commit health care fraud. Some examples include:

• Doctors billing for care they never provided
• Altering medical records to make it look like someone received more care than they actually did
• Prescribing unnecessary treatments or drugs
• Accepting kickbacks for referring patients to other providers

When someone commits health care fraud, it raises the cost of health care for everyone. In fact, about 10 cents of every dollar spent on health care goes toward paying for fraudulent claims.

There are laws in place to try to prevent health care fraud, and agencies like the Federal Bureau of Investigation and the U.S. Postal Service investigate cases of fraud. If someone is caught committing health care fraud, they could face fines, jail time, and lose their license to practice medicine.

Examples of health care fraud include:

• A doctor billing for a procedure they never performed
• A patient lying about their income to qualify for free health care services
• A pharmacist selling prescription drugs on the black market

These examples illustrate how people can commit health care fraud in different ways, whether it's by lying about their qualifications or selling drugs illegally. No matter how it's done, health care fraud is a serious crime that hurts everyone.