In fiscal year 2011, 48.4 million individuals were enrolled in Medicare; 55.6 million in Medicaid, and 8.7 million in the Childrens Health Insurance Program (CHIP). Together, these programs accounted for approximately $849.2 billion in federal expenditures. The federal government allocated at least $608 million in funding to investigate and prosecute cases of alleged health care fraud in health care programs that year. Many different types of providers and suppliers who serve Medicare, Medicaid, and CHIP beneficiaries are subjects of fraud cases, including physicians, hospitals, durable medical equipment suppliers, home health agencies, and pharmacies. This book provides an overview of select investigations into health care fraud.
Preface; Health Care Fraud:: Types of Providers Involved in Medicare, Medicaid & the Childrens Health Insurance Program Cases; Medicare:: Higher Use of Advanced Imaging Services by Providers Who Self-Refer Costing Medicare Millions; Index.
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