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Medicare fraud. In the United States, Medicare fraud is the claiming of Medicare health care reimbursement to which the claimant is not entitled. There are many different types of Medicare fraud, all of which have the same goal: to collect money from the Medicare program illegitimately. [1]
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.
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HealthCare.gov is a health insurance exchange website operated by the United States federal government under the provisions of the Affordable Care Act or ACA, commonly referred to as "Obamacare", which currently serves the residents of the U.S. states which have opted not to create their own state exchanges. [1][better source needed] The ...
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.
Theranos Inc. (/ ˈ θ ɛr. ə n. oʊ s /) was an American privately held corporation [5] that was mistakenly touted as a breakthrough health technology company. Founded in 2003 by then 19-year-old Elizabeth Holmes, Theranos raised more than US$700 million from venture capitalists and private investors, resulting in a $10 billion valuation at its peak in 2013 and 2014.
The Fodder Scam was a corruption scandal that involved the embezzlement of about ₹940 crore (equivalent to ₹ 48 billion or US$570 million in 2023) from the government treasury of the north Indian state of Bihar. [1] Among those implicated in the theft and arrested were then Chief Minister of Bihar, Lalu Prasad Yadav, [2] as well as former ...
Another motivation for insurance fraud is a desire for financial gain. Public healthcare programs such as Medicare and Medicaid are especially conducive to fraudulent activities, as they are often run on a fee-for-service structure. [25] Physicians use several fraudulent techniques to achieve this end.