Medicare, Medicaid, CHIP All Targets For Fraud

Kaiser Health News: OCTOBER 12TH, 2012

When it comes to health care fraud, medical facilities and hospitals are the top two offenders. That’s according to a new Government Accountability Office report released this week.

According to the report, 10,187 individuals and entities were investigated in 2010 for defrauding Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Medical facilities (including medical centers, clinics, and medical practices) and medical equipment suppliers represented the bulk of criminal investigations. Hospitals were the most frequent subjects of civil cases.

The GAO analyzed data from government sources, including the Department of Health and Human Services’ Office of the Inspector General, the Department of Justice (which included the FBI) and 10 state Medicaid Fraud Control Units. Forty percent of those state investigations for fraud in Medicaid and CHIP in 2010 were home health care providers and health care practitioners. Read more