What are the legal reprecussions of using fraudulent insurane documentation to get coverage for certain medical treatments?

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Question:

I work in the business office of a medical clinic, and I suspect that my supervisor is overbilling for certain medical services by filing fraudulent insurance documents.  Isn’t that illegal?

Answer: (1)

Insurance fraud is a felony.  It may seem like a “victimless crime” to some, but in the long run it costs consumers in higher insurance rates and in turn, inflated costs of goods and services.  According to the National Insurance Crime Bureau (NICB), insurance crime nationwide costs $20 billion annually.  A falsified medical billing statement with fake insurance documentation may involve some or all of the following:  billing for treatment that was never provided, medical tests that were never conducted, supplies that were not used, cancellation charges for office calls that were never scheduled, and referral fees for services that were never rendered.   Those who are convicted of crimes involving fraudulent insurance documents often serve time in jail and are ordered to pay back the money.  For more information about White Collar Crimes involving fake insurance documentation, seek the advice of a criminal defense lawyer.

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