Medicaid: Examples of Medicaid Fraud for Whistleblowers in NY
- “Phantom billing.” Phantom billing is the practice of billing for medical services not actually performed.
- “Upcoding.” Upcoding is the practice of billing for a more expensive service than the service that was actually provided to the patient.
- “Unbundling.” Unbundling is the practice of billing for several services that should be combined into one billing.
- “Duplicate billing.” Duplicate billing is the practice of billing twice for the same medical service.
- “Kickbacks.” A Kickback is the practice of giving or accepting gifts in return for medical services.
- Dispensing generic drugs and billing for name brand drugs thereby obtaining an unfair profit.
- “Providing unnecessary services.” Providing unnecessary services can include treating a patient beyond the time necessary to achieve the patient’s maximum health benefit.
These are just a few of the examples of Medicaid Fraud. Doctors and business owners who commit Medicaid fraud are stealing money from the public. They are unfairly draining valuable public resources. Every time someone commits Medicaid fraud, they are stealing money that could be used for purchasing new school books, fixing our bridges, or caring for our elderly. In the end, their dishonesty is raising taxes and putting their needs ahead of their patient care and public good. You can help put an end to this and blow the whistle. Call Villanueva & Sanchala, PLLC for a confidential consultation at 800-893-9645.