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  2. Health care fraud - Wikipedia

    en.wikipedia.org/wiki/Health_care_fraud

    Under federal law, health care fraud in the United States is defined, and made illegal, primarily by the health care fraud statute in 18 U.S.C. § 1347 states [4] (a) Whoever knowingly executes, or attempts to execute, a scheme or artifice—. (1) to defraud a financial institution; or. (2) to obtain, by means of false or fraudulent pretenses ...

  3. Medicare fraud - Wikipedia

    en.wikipedia.org/wiki/Medicare_fraud

    Jimmy Carter signs Medicare-Medicaid Anti-Fraud and Abuse Amendments into law. The Office of Inspector General for the U.S. Department of Health and Human Services, as mandated by Public Law 95-452 (as amended), is established to protect the integrity of Department of Health and Human Services (HHS) programs, to include Medicare and Medicaid programs, as well as the health and welfare of the ...

  4. Insurance fraud - Wikipedia

    en.wikipedia.org/wiki/Insurance_fraud

    The National Health Care Anti-Fraud Association estimates that 3% of the health care industry's expenditures in the United States are due to fraudulent activities, amounting to a cost of about $51 billion. [9] Other estimates attribute as much as 10% of the total healthcare spending in the United States to fraud—about $115 billion annually. [10]

  5. 2014 Veterans Health Administration controversy - Wikipedia

    en.wikipedia.org/wiki/2014_Veterans_Health...

    The 2014 Veterans Health Administration controversy is a reported pattern of negligence in the treatment of United States military veterans. Critics charged that patients at the VHA hospitals had not met the target of getting an appointment within 14 days. In some hospitals, the staff falsified appointment records to appear to meet the 14-day ...

  6. Medicare Fraud Strike Force - Wikipedia

    en.wikipedia.org/wiki/Medicare_Fraud_Strike_Force

    United States. The Medicare Fraud Strike Force is a multi-agency team of United States federal, state, and local investigators who combat Medicare fraud through data analysis and increased community policing. Launched in 2007, the Strike Force is coordinated by the United States Department of Justice and the Department of Health and Human Services.

  7. False Claims Act of 1863 - Wikipedia

    en.wikipedia.org/wiki/False_Claims_Act_of_1863

    Wisconsin Bell, Inc. v. United States ex rel. Todd Heath, No. 23-1127, ___ U.S. ___ (2025) The False Claims Act of 1863 (FCA) [ 1 ] is an American federal law that imposes liability on persons and companies (typically federal contractors) who defraud governmental programs. It is the federal government's primary litigation tool in combating ...

  8. 2010 Medicaid fraud - Wikipedia

    en.wikipedia.org/wiki/2010_Medicaid_fraud

    A case of Medicaid fraud was carried out in 2010 by an Armenian-American organized crime group called the Mirzoyan–Terdjanian organization. [1] [2] The scam involved a crime syndicate which created 118 fake clinics in 25 states and used stolen medical license numbers of real doctors and matched them to legitimate Medicare patients whose names and billing information were also stolen.

  9. Anti-Kickback Statute - Wikipedia

    en.wikipedia.org/wiki/Anti-Kickback_Statute

    The Anti-Kickback Statute (AKS) is an American federal law prohibiting financial payments or incentives for referring patients or generating federal healthcare business. The law, codified at 42 U.S. Code § 1320a–7b(b), [1] imposes criminal and, particularly in association with the federal False Claims Act, civil liability on those who knowingly and willfully offer, solicit, receive, or pay ...