7 of The Biggest Health Insurance Fraud Takedowns of 2020
2020 was a banner year for health insurance scams. Here are seven of the largest takedowns of the year. Keep in mind, these are just the ones that have been detected. Billions of dollars of fraud activity likely goes completely unnoticed, leaving insurance companies on the hook.
1. $56 MILLION FRAUD CONSPIRACY IN TELEMEDICINE CO.
The owners of two telemedicine companies have been charged for allegedly devising a nationwide healthcare fraud scheme that resulted in $56 million in false and fraudulent claims to Medicare.
2. CHIROPRACTOR CHARGED WITH COVID-19, HEALTHCARE FRAUD
A Florida based chiropractor was charged with fraudulently obtaining loans from key COVID-19 relief programs. He allegedly used his office to submit false and fraudulent claims for reimbursement from Medicare and CareCredit.
3. $1.4 BILLION RURAL HOSPITAL BILLING SCHEME
In the rural south, 10 conspirators allegedly billed private payers approximately $1.4 billion for laboratory testing claims, out of which they were paid about $400 million.
4. $681 MILLION SUBSTANCE ABUSE TREATMENT FRAUD
A Florida based substance abuse doctor was charged with conspiracy to commit healthcare fraud and wire fraud for allegedly engaging in fraudulent billing for tests and treatments. The scheme resulted in $681 million in fraudulent claims.
5. $325 MILLION HEALTHCARE FRAUD SCHEME IN TX.
A Texas rheumatologist was found guilty of falsely diagnosing patients with life-long diseases – and treating them with medically unnecessary and toxic medications – as part of a $325 million healthcare fraud scheme.
6. TEXAS PHYSICIAN SENTENCED 84 MONTHS FOR HEALTHCARE FRAUD
A Texas physician and anesthesiologist received seven years in prison for his role in fraudulently billing healthcare programs. The doctor billed healthcare providers for nearly $5 million, which also resulted in multiple patient deaths.
7. $150 MILLION HEALTHCARE FRAUD SCHEME IN MI
Four Michigan doctors were found guilty for participating in a Medicare fraud scheme that cost the federal healthcare program $150 million. They billed Medicare for medically unnecessary services, including facet joint injections, urinary drug screens, and home healthcare.
Source: https://revcycleintelligence.com/news/top-healthcare-fraud-takedowns-of-2020
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