insuranceshot.com

Floridas Fight Against Medical Insurance Fraud and its Unintended Victims

It's estimated that Medicare, Medicaid and private medical insurance fraud costs the $2 trillion healthcare industry in excess of $100 billion dollars per year. In the current economic environment, "controlling rising healthcare costs" and "enforcing fiscal discipline" are two talking points that appear in every politician's public agenda. Often you'll hear politicians and the news media employ the word "crisis" to justify a call to action.

There's no doubt that Medicare, Medicaid and private insurance fraud are significant problems in a state like Florida. However, as is the case whenever any issue becomes topical, the reaction can sometimes be so zealous that the need for agencies to report impressive arrest numbers begins to take priority over the responsible prosecution of the crimes. Doctors and medical personnel who may have only made billing errors or unwittingly associated themselves with unscrupulous employees or patients often find themselves to be the subject of a Medicare, Medicaid or private insurance fraud investigation. A resulting criminal charge could result in the loss of licensing, irreparable damage to one's professional reputation, the payment of fines and even jail time.

Here are a few examples of the types of activities that agencies like the Florida Department of Insurance Fraud typically investigate, but can often be confused with legitimate medical billing processes: