Health fraud prevalent, costly
By: Mark Gruba
Updated: March 18, 2013
Health fraud is prevalent and costly, especially when it comes to medicine fraud.
CPA Tim Hungerford of Hungerford Vinson LLC discussed the topic Monday morning on News 8 at Sunrise.
Hungerford said health fraud impacts everyone, including the elderly and chronically ill. He said it's crucial people be wary of drugs that make false promises, like those tied to weight loss or youthful appearances. Many have not been tested by the FDA and could have harmful side effects.
Hungerford recommended visiting the FDA site online to determine if a drug is on the approved list. If it's not, then you should stay away from it. You should also be wary of payment programs, where the seller wants you to sign up for regularly scheduled shipments and automatic credit card charges. In general, you should look out for aggressive sales approaches.
It's estimated losses due to health fraud top $100 billion a year. Fraud increases the cost to employers providing benefits.
Hungerford said there are several steps you can take to prevent health fraud and protect yourself. When your receive your Explanation of Benefits, or EOB, form make sure the visit and procedure actually happened. Fraudulent providers will submit phantom claims, upcoding for more lucrative services, duplicate submissions or unbundle services to increase payments received.
Hungerford added when a co-pay or deductible is waived by your provider that's a sign something is being manipulated. He also said safeguard your insurance card the same way you do your credit card.
If you suspect health fraud contact the New York State Department of Health, Office of Professional Medical Conduct at 1-800-663-6114.
CPA Tim Hungerford of Hungerford Vinson LLC discussed the topic Monday morning on News 8 at Sunrise.
Hungerford said health fraud impacts everyone, including the elderly and chronically ill. He said it's crucial people be wary of drugs that make false promises, like those tied to weight loss or youthful appearances. Many have not been tested by the FDA and could have harmful side effects.
Hungerford recommended visiting the FDA site online to determine if a drug is on the approved list. If it's not, then you should stay away from it. You should also be wary of payment programs, where the seller wants you to sign up for regularly scheduled shipments and automatic credit card charges. In general, you should look out for aggressive sales approaches.
It's estimated losses due to health fraud top $100 billion a year. Fraud increases the cost to employers providing benefits.
Hungerford said there are several steps you can take to prevent health fraud and protect yourself. When your receive your Explanation of Benefits, or EOB, form make sure the visit and procedure actually happened. Fraudulent providers will submit phantom claims, upcoding for more lucrative services, duplicate submissions or unbundle services to increase payments received.
Hungerford added when a co-pay or deductible is waived by your provider that's a sign something is being manipulated. He also said safeguard your insurance card the same way you do your credit card.
If you suspect health fraud contact the New York State Department of Health, Office of Professional Medical Conduct at 1-800-663-6114.
