Medicare reimbursement requires doctors to perform proper tests and treat their patients with care. Medical malpractice has been the downfall of many a reputable medical center. When these doctors don’t perform their jobs to the fullest, they end up being sued. Medicare reimbursement fraud is one of the most common reasons for lawsuits against medical facilities. It is also one of the reasons why victims of medical malpractice often pay higher hospital bills and suffer long-term disabilities.
Rick Scott Fraud and Abuse Cases
Medicare reimbursement may not be a direct hit against Rick Scott fraud and abuse cases, but it can definitely sway legal proceedings. Medical financial incentives are likely to be the main culprit here, and in any case other cases of Medicare fraud and abuse.
When unnecessary surgical procedures are carried out on patients, hospitals flourish.
In reality, Medicare reimbursement benefits a great deal to hospitals, both in terms of revenue and reputation. The practice of overcharging patients and then covering it up with false billing is considered to be Medicare spousal abuse by many patients’ rights advocates. In the event a physician performs fraudulent acts with patients’ compensation going to the hospital, the Rick Scott doctor may be charged with a federal criminal offense. Such charges may include tax evasion, perjury, and violation of numerous sections of the healthcare legislation.
The Office of Professional Responsibility for Medicare Reimbursement
This problem has become so rampant that it has prompted the creation of a new office, the Office of Professional Responsibility for Medicare Reimbursement, or the OPR MBA, to monitor and discipline physicians who commit these offenses. The OPR MBA will soon require all physicians to be formally trained and to pass an exam in order to be accredited. This will only apply to doctors who work in hospitals, which are required by law to report suspected fraud. The general population, however, is not required to report to the OPR MBA.
The National Commission for Health Care Professionals
Many doctors have simply decided to do nothing as the specter of possible legal action looms over them. Unfortunately, in these circumstances, victims may not be able to put their complaints forward to the right authorities. Some patients are even afraid to report their abuses out of fear for what could happen to them. 
Doctors, meanwhile, may have a very hard time understanding why their actions are being investigated even when they are unaware of what is going on. There have been efforts to address this problem by the creation of the National Commission for Health Care Professionals, or the NCHP. The creation of the NCHP ensures that any doctor who is suspected of committing a fraudulent act will be brought to the attention of patients and other medical professionals. In some states, medical insurance fraud is covered by medical malpractice laws that allow patients to file lawsuits in cases where they have been injured due to a doctor’s negligence. In response to the issue of rampant medical malpractice, the government has recently taken several steps to reform the healthcare system, such as the Health Insurance Portability and Accountability Act (HIPAA). However, it is up to patients themselves to take the steps necessary to report any Medicare or Medicaid fraud they may encounter.
How to Report Medicare Fraud
If you are aware or suspect Medicare fraud it is your duty to report it.
- Call Medicare 1-800-medicare (800-633-4227)
- Call the Medicare Drug Integrity Contractor 877-772-3379
