Medicare fraud


Medicare fraud

A generic term for any unlawful act which results in the inappropriate billing of Medicare for services by a healthcare provider, including physicians, hospitals and affiliated providers.
 
Examples
Billing for or performance of duplicated services, claims for services not rendered, billing for services not deemed medically necessary, miscoding of medical and/or surgical procedures, excess charges for services or supplies, breech of assignment agreements, billing Medicare patients at a higher or different fee schedule, waivers of co-payments and deductibles, and other improper billing practices.

Medicare fraud

Medifraud Medical practice Any unlawful act which results in the inappropriate billing of Medicare for services by a health care provider–eg, physicians, hospitals and affiliated providers. See Medicare.