Medicare And Medicaid Fraud

AAA

DEFINITION of 'Medicare And Medicaid Fraud'

Illegal practices aimed at getting unfairly high payouts from government-funded healthcare programs. There are many types of Medicare and Medicaid fraud, including billing for services that weren't provided (phantom billing, upcoding), performing unnecessary tests or giving unnecessary referrals (pingponging), charging separately for services that are usually charged at a package rate (unbundling) and many more.

INVESTOPEDIA EXPLAINS 'Medicare And Medicaid Fraud'

Medicare and Medicaid fraud are a multi-billion dollar drain on a system that is already expensive to maintain. There are external auditors who are responsible for reviewing suspicious claim patterns, but the sheer volume means that many frauds can go undetected for years.

RELATED TERMS
  1. Corporate Fraud

    Activities undertaken by an individual or company that are done ...
  2. Fake Claims

    The term fake claims refers to insurance claims that are made ...
  3. Medicare

    A U.S. federal health program that subsidizes people who meet ...
  4. Medicaid

    A joint federal and state program that helps low-income individuals ...
  5. Healthcare Sector

    A category of stocks relating to medical and healthcare goods ...
  6. Member Month

    The number of individuals participating in an insurance plan ...
Related Articles
  1. Home & Auto

    Fighting The High Costs Of Healthcare

  2. Insurance

    Services That Health Insurers Often ...

  3. Options & Futures

    What's The Difference Between Medicare ...

  4. Insurance

    What Does Medicare Cover?

Hot Definitions
  1. Capitulation

    When investors give up any previous gains in stock price by selling equities in an effort to get out of the market and into ...
  2. Turkey

    Slang for an investment that yields disappointing results or turns out worse than expected. Failed business deals, securities ...
  3. Conduit Issuer

    An organization, usually a government agency, that issues municipal securities to raise capital for revenue-generating projects ...
  4. Financing Entity

    The party in a financing arrangement that provides money, property, or another asset to an intermediate entity or financed ...
  5. Hyperinflation

    Extremely rapid or out of control inflation. There is no precise numerical definition to hyperinflation. Hyperinflation is ...
  6. Gross Rate Of Return

    The total rate of return on an investment before the deduction of any fees or expenses. The gross rate of return is quoted ...
Trading Center