Criminals are extremely active with healthcare frauds in the USA today. These scams were common even before the coronavirus pandemic broke out across the globe and the implementation of the Affordable Care Act or the ACA. The state and federal law enforcement agencies are now on a mission to catch the culprits and mitigate healthcare fraud cases in the nation.
Esteemed healthcare lawyer John M. LeBlanc, partner, national healthcare litigation, Manatt, Phelps & Phillips, says, “In many cases, frontline healthcare workers place their lives at risk daily, caring for those infected with the highly contagious virus. Unfortunately, less than honorable people living among us will go to great lengths to profit from this pandemic and take advantage of leniency intended on helping the medical community treat patients more effectively.”
John LeBlanc of Manatt says that as people continue to reside in the coronavirus age, all parties interested in battling fraud like the local, state, and federal governments should continue to investigate and later prosecute offenders linked to healthcare fraud nation. He says the recipients of government funds designed to stop COVID-19 from spreading should pay close attention to all the parameters and laws related to funding.
Healthcare personnel is involved in scams
It is no surprise that corporate fraud committed by healthcare providers accounts for the biggest percentage of corporate fraud in the nation. The reason being is they can copy legitimate transactions with doctors who are complicit and other healthcare professionals that can manipulate or even bypass the internal controls. He says that fraud from inside the system itself makes its detection challenging. The presence of the COVID-19 pandemic only makes the situation worse.
In the above case, every healthcare provider who gets payments from the Provider Relief Fund is under the obligation to certify its proper use and prove that these funds are to be used for the above purposes only. Besides the above, they should attest to the terms and conditions that are linked to the payments and reference all the relevant regulations and statutes.
John LeBlanc of Manatt sums up by saying, “Currently, Medicare processes more than 4.5 million claims a day. A likely target of increased governmental focus is those who received the Provider Relief Fund funds created as part of the more expansive Coronavirus Aid, Relief, and Economic Security Act.”
Besides the above case, there is a fraud that is linked to government relief programs like the PFR and other instances of counterfeit claims that are increasing. They also cover medical supplies, fraudulent vaccines, and a rise in fake vaccination records. He says that counterfeit items are a dangerous threat to the overall health and safety of the public at large, especially when the new COVID-19 variants are highly transmissible in the nation. The issue is dangerous, and it needs to be mitigated by the nation quickly.