Healthcare Fraud

Healthcare fraud is a type of white-collar crime that involves the filing of dishonest health care claims in order to turn a profit. Fraudulent health care schemes come in many forms. Practitioner schemes include: individuals obtaining subsidized or fully-covered prescription pills that are actually unneeded and then selling them on the black market for a profit; billing by practitioners for care that they never rendered; filing duplicate claims for the same service rendered; altering the dates, description of services, or identities of members or providers; billing for a non-covered service as a covered service; modifying medical records; intentional incorrect reporting of diagnoses or procedures to maximize payment; use of unlicensed staff; accepting or giving kickbacks for member referrals; waiving member co-pays; and prescribing additional or unnecessary treatment.  When a health care fraud is perpetrated, the health care provider passes the costs along to its customers. Because of the pervasiveness of health care fraud, statistics now show that 10 cents of every dollar spent on health care goes toward paying for fraudulent health care claims.

FAU offers a certificate program to provide students with specialized knowledge relating to healthcare fraud and abuse investigations.

April 2014

Healthcare and Financial Fields Face Huge Impending Boom – Are You Prepared?

By |2017-03-07T19:33:58+00:00Wednesday, April 16, 2014|Tags: , , , , , , , , , , |

The year 2014 is proving to be a monumental one as it relates to the healthcare and finance professions.  There are several major reasons as to why companies are literally clawing and scratching to find qualified, educated professionals to fill

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