How is health care fraud committed?

Health care fraud is a type of white collar crime that is committed when an individual or organization knowingly deceives a health care system for financial gain. It may involve submitting false information for reimbursement, submitting multiple claims for the same services, or providing medical services that are not medically necessary. In South Dakota, health care fraud is primarily committed by submitting false or inaccurate bills or claims for reimbursement or services that were not actually provided. For example, a health care provider might submit a false claim for a procedure that was never performed, or a person might submit a claim for medical services that their insurance actually covers, but they never actually received the services. Other methods of committing health care fraud include overbilling, upcoding services, ordering unnecessary tests, submitting false invoices to billing departments, double-billing, or accepting kickbacks from other health care providers. In South Dakota, it is illegal to provide false or misleading information when making a claim for reimbursement, and those caught doing so may face steep financial fines or jail time.

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How is health care fraud committed?

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