Fraud is the intent to deceive in order to gain an unfair or undeserved advantage or benefit. Healthcare fraud is widespread (Rosenbaum et al. 2009, 1).
Examples of fraud include fraudulent billing, kickbacks, upcoding, and ghost patients (Rosenbaum et al. 2009, 2).
As can be deduced from the examples, most people who commit fraud are healthcare providers.
Go to the Office of Inspector General Fraud Enforcement Actions website: https://oig.hhs.gov/fraud/enforcement/
Find a fraud case that involves fraudulent billing, kickbacks, upcoding, or ghost patients. Summarize the case and explain how the fraud was committed.
Sample Solution