What is health care fraud?
Health care fraud is a type of consumer fraud specifically related to the health care system. In the state of Oklahoma, health care fraud is a crime that occurs when someone knowingly and willfully defrauds or attempts to defraud any health care benefit program, or a patient in connection with the delivery of or payment for health care benefits, services, or supplies. Examples of health care fraud include submitting false or misleading information to receive healthcare services or reimbursement, double-billing for health care services already paid for, misrepresenting the type of service provided, using a provider number obtained without authorization, or accepting kick-backs or bribes for services. Health care fraud can take many forms and is not limited to just the providers of health care services. Health care fraud can also be committed by patients, providers, employers, and even insurance companies. The Oklahoma Health Care Authority (OHCA) is tasked with investigating suspected fraud and prosecuting cases of fraud when necessary. Health care fraud is a serious crime that can lead to serious criminal and civil consequences, including fines, restitution, and prison time. In Oklahoma, if convicted of health care fraud, you may face up to 10 years in prison and/or a fine of up to $50,000. In addition, the OHCA can impose administrative sanctions, such as revoking a health care provider’s license to practice in Oklahoma. It is important to understand the laws and regulations related to health care fraud in order to protect yourself and your family from becoming victims of fraudulent activities.
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