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MEDICAL INSURANCE FRAUD
MEDICAL
CHIRO TALK
DISABILITY
DURABLE MEDICAL EQUIPMENT
MEDICAID
PRESCRIPTION
LAY OWNERSHIP
SSI
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Medicaid Fraud
First a brief description covering the difference between Medicare and Medicaid.
Medicare is for the old and disabled, regardless of income. Medicaid is for the
poor. Medicare has its rates set by the Feds and is paid directly out of Federal
coffers. Medicaid also has its rates set by the Feds, but the payments come from
the States (or from cities, with States making a contribution.)
If a Doctor is defrauding the system, he's usually doing it one of three ways:
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He really sees the patient and provides a
service...but he bills for a higher level of service or more services
than he actually delivered.
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He invents patients and bills for service that
never was given.
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Sometimes it is the patient defrauding the
system...and the doctor knows nothing about it. The most common occurrence is
when someone with coverage (and a card) lends his card to somebody else and that
somebody else gets treated.
No matter what the fraud, however, these benefits are paid out of Federal or
State budgets, and THOSE are funded by taxes.
Who pays the taxes? YOU DO.
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