FBI releases healthcare fraud information
Compliance Monitor, May 28, 2008
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The FBI investigated 2,493 cases of healthcare fraud in fiscal year 2007, leading to 635 convictions, according to an agency report.
Those cases lead to:
- $1.12 billion in restitutions
- $4.4 million in recoveries
- $34 million in fines
- 308 seizures valued at $61.2 million
The FBI estimates fraudulent billing accounts for between 3% and 10% of all healthcare expenditures. CMS estimates $2.26 trillion was spent on healthcare in fiscal year 2007.
In the report, the FBI identified the most common types of healthcare fraud as:
- Billing for services not rendered
- Upcoding
- Duplicate claims
- Unbundling
- Excessive services
- Medically unnecessary services
- Kickbacks
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