Can business practices result in health care fraud?

On Behalf of | Jul 26, 2021 | White Collar Crime, white collar crimes

While you may realize that health care fraud is a problem, it may seem like the kind of thing that will never happen at your practice. However, you may face allegations of fraud because of the way that you conduct your business practices.

Health care fraud can take many forms.

Kickbacks

According to the Centers for Medicare and Medicaid Services, accepting kickbacks is one type of health care fraud. Kickbacks may consist of monetary compensation for recommending that patients see certain providers or receive certain treatments. However, kickbacks can also take the form of reduced rent for office space, meals and stays in luxury hotels.

Vendor relationships

Sometimes, the way you work with your vendors may result in allegations of health care fraud. While you can receive free samples from drug companies, you cannot sell these samples. If you store free samples with other medications that you dispense, you may charge your patients for them.

Additionally, some pharmaceutical companies may ask you to consult for them. In some situations, these consultations may be legal. However, you may unintentionally commit health care fraud if you accept compensation that exceeds the services you provide.

Overbilling

You may also face accusations of health care fraud if you overbill your patients. This may take a few different forms. You may charge your patients too much for certain services. You may also send a bill for a service that a patient did not need. Sometimes, overbilling may happen by mistake. One of your staff members may use the wrong billing code, for example. If this continually happens, though, you or someone at your practice may commit fraud.

Allegations of health care fraud can harm your reputation. If you think that some of your business practices may potentially fall under this category, you should usually stop these practices. You may also want to report the fraudulent practices of vendors that you work with.

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