Medicare Fraud
Medicare fraud can take many forms, and costs taxpayers billions of dollars every year. Medicare fraud as it relates to the False Claims Act involves the submission of false claims (invoices, Form 1500, cost reports) to Medicare, for payment by Medicare, knowing that the claims were false. The following pages describe representative examples of various types of Medicare fraud.
- Overview – summary of the various types of Medicare fraud.
- Medicare Fraud Contact Form - form to provide information about Pharmaceutical fraud to the firm.
- Hospital Inpatient Fraud - describes fraud involving lack of medical necessity to support inpatient status.
- Hospital Outpatient Fraud – describes upcoding under the OPPS.
- SNF Fraud – describes Skilled Nursing Facility reimbursement.
- LTACH Fraud – describes fraud involved with Long Term Acute Care Hospitals.
- Cost Report Fraud – describes the applicability of cost report fraud.
- Medicare Advantage Risk-Scoring Fraud – describes fraud involved with managed care which is paid for by Medicare.