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Fraud Schemes in the Medicare Systems

Fraud in many health cares or Medicare systems across the continent has been identified as one of the most challenging problems that have been going on which has greatly negatively affected the delivery of the health services to the people.

Medicare systems mostly includes some of the expenses that may be incurred in getting a medical service. Any person who might have an intention of seeking some Medicare services like getting a medical equipment should first meet any requirement and regulation for a Medicare medical necessity and also have a certificate showing any of his or her medical need which should also be certified by a trained physician through a legal signature. Most of the durable medical equipment suppliers usually purchase the medical equipment from some of the medical equipment manufacturers and hence by this middlemen activities some of them might engage in fraudulent activities before shipping this medical equipment to the patients and this mainly makes the patients be at a big risk of being affected by the fraud activities of these middlemen.

The following are some of the various fraud schemes used by the durable medical equipment suppliers who are fraudsters to the patients.Many fraudsters who supply the medical equipment to the patients deliver the durable medical equipment to the patients before having the required physician notice and order which mainly comprises the patient’s certificate of medical necessity and other patient needs. The other fraud scheme practiced by the durable medical equipment fraudsters is delivering more of the medical equipment than the amount which is needed or which is ordered which exceed the lifespan of the medical equipment.

Failure of recording the amount of durable medical equipment returned by the patients is also another fraudulent activity that has been keenly noted by many departments of justice to try to curb it. Another fraud scheme noted by the department of justice is the intentional misinterpretation of the amount of cash paid to them by the patients.

Many markets which have been associated with criminal activities have emerged due to increased Medicare fraudsters who practice some of the above fraud schemes. There have been various methods that have been put forward by the governments to help curb and control these Medicare fraudsters for example establishment of some rules and regulations and other bodies like Health Care Fraud Prevention and Enforcement Action.

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