The Top 5 Healthcare Fraud Cases in Recent Years You Need to Know About
Healthcare fraud is an alarming criminal offense that poses severe risks to the healthcare industry, government programs such as Medicare and Medicaid, and patients. In recent years, there have been several notorious healthcare fraud cases that have made headlines nationwide due to their severity and magnitude. In this blog post, we’ll highlight the top 5 healthcare fraud cases in recent years that you need to know about.
1. The Insys Therapeutics Case
The Insys Therapeutics case is one of the most notorious healthcare fraud cases in recent history. The company was found guilty of bribing doctors to prescribe their opioids, including Subsys, a highly addictive fentanyl spray, and defrauding insurance companies to pay for it. Insys paid millions of dollars to doctors in return for them prescribing Subsys to patients who did not need it, resulting in opioid addiction and overdose deaths.
2. The Medicaid Fraud Case Against C.R. Bard
In 2016, medical device manufacturer C.R. Bard paid $48.5 million to settle allegations of Medicaid fraud. The company was accused of promoting and marketing its cancer device to healthcare providers who used it for unapproved purposes in female patients. As a result, Medicaid paid for procedures that were not medically necessary, resulting in significant financial losses.
3. The UnitedHealth Group Case
In 2017, the UnitedHealth Group was sued for defrauding the Medicare program and overcharging for its insurance plans. The company was accused of manipulating the Medicare Advantage program by fraudulently increasing patients’ risk scores and charges, resulting in more significant profits for the company. The lawsuit alleged that UnitedHealth had overcharged taxpayers by hundreds of millions of dollars, resulting in significant financial losses.
4. The Quest Diagnostics Fraud Case
In 2017, Quest Diagnostics settled a case with the state of California for $241 million after allegations of Medicare fraud. The company was accused of overcharging Medicare for unnecessary tests, billing for tests that were not ordered by doctors, and engaging in other fraudulent billing practices. As a result, Medicare paid millions of dollars in reimbursements for tests that were not necessary and did not benefit patients.
5. The Tenet Healthcare Case
In 2016, Tenet Healthcare paid $513 million to settle allegations of healthcare fraud. The company was accused of overbilling Medicare and Medicaid for services that were not necessary, offering kickbacks to physicians for referring patients to their hospitals, and defrauding the government healthcare programs. The settlement was one of the largest healthcare fraud settlements in history.
In conclusion, healthcare fraud is a severe crime that poses significant risks to the healthcare industry, government programs, and patients. The cases highlighted in this blog post are just a few of the healthcare fraud cases that have made headlines in recent years. By raising awareness of these cases, we hope to highlight the importance of preventing healthcare fraud and protecting patients and the healthcare industry from its devastating effects.
