Medicare Fraud

Medicare fraud is a general term that refers to an individual or corporation that seeks to collect Medicare health care reimbursement under false pretenses. Common forms of Medicare fraud include:
 * 1) Services not rendered
 * 2) Upcoding schemes and Unbundling
 * 3) Kickbacks and Self Referrals
 * 4) Falsely Certifying and Giving False Information
 * 5) Lack of medical necessity
 * 6) Fraudulent Cost Reports

Those responsible for reporting Medicare fraud include:


 * 1) The Centers for Medicare & Medicaid Services (CMS)
 * 2) People with Medicare
 * 3) Providers of Medicare services including physicians, providers, and suppliers
 * 4) State and Federal Agencies such as, the Department of Health and Human Services Office of the Inspector General, the Federal Bureau of Investigation (FBI), and the Department of Justice.