You may think that healthcare fraud does not have anything to do with your private practice. However, some of your practices may get you into trouble if people think they see signs of fraud.
There are several ways that your medical practices may be fraudulent.
Collaborations with vendors
According to the U.S. Department of Health and Human Services, people may accuse you of committing healthcare fraud if they think you have suspicious relationships with your vendors. You may receive free samples of different medications from pharmaceutical companies. However, your practice cannot legally sell these samples. If you or one of your staff members bills Medicare after providing a sample to your patients, this may be a form of healthcare fraud.
Additionally, your agreements with different companies may get you into trouble. You may sometimes serve as a consultant for pharmaceutical companies. If people think that you are recommending certain medications or medical products because of your affiliation with the company, you may face allegations of healthcare fraud.
The bills that you send to Medicare could cause you to experience problems. Medicare may often pay 80% of a patient’s bill and you may bill your patients for the other 20%. If you send a bill for more than this 20%, you may face repercussions.
Additionally, you usually need a unique National Provider Identifier. If one of your staff members submits a false bill under this number, you may be accountable. This false bill may be for services that a patient did not need or that your practice did not perform.
Healthcare fraud can damage your reputation as a physician. If you are facing these allegations, it is important for you to take action to protect yourself and your practice.