There are many different avenues of white collar crime. One of the biggest criminal organizations is shockingly the health care industry. Health care fraud is committed by dishonest health care providers and even by the health care plan holders, meaning we the people. Crime by the providers can stem from a lot of different things. Giving a false diagnosis to justify tests and procedures that are unnecessary, billing for medical procedures that were not really performed or that were not really needed, waiving member co-pays and over-billing the insurance provider instead, misrepresenting non-covered procedures as covered ones. These are a chuck of the many sneaky crimes committed by these companies. And the worst part about it is that in most scenarios the victim of the crime has no idea of the unfair treatment and always lack the knowledge about the health care industry to even point out something as crafty as a bill for a treatment never done.
But health care plan holders are not free from the evil works some of them commit. Unfortunately we live in a society where if there is a window for people to get away with an act, almost 50 percent of the time people will take that opportunity. But all acts committed in dark must come to light, right?
So here are the ways we tend to do our own doing of white collar crime. Altering health care bills or forging them to get health care reimbursements; Filing claims for medical procedures and/or prescription medication that you did not receive, using someone else's insurance card or allowing someone else to use yours. These are some of the type crimes people attempt to get away with, but when caught it not only hurts the person but also the industry as a whole.
Although white collar crimes seem to go undetected and when detected, little is done to the criminals committing the act, there are consequences. Federal law provides civil and criminal penalties for health care fraud. The penalties that one can face if convicted of health care fraud could include, lengthy jail or prison time, fine of up to $250,000, restitution for any amount that the defendant profited, probation, and loss of professional license are some of the punishments for these action.
The bulk of health care fraud is done by a small group of dishonest providers. No matter the size of the group, their crime make an impact on the industry. Unfortunately when these actions are committed it ruins the reputation of our health care industry, but this is the world we live in. The amount of money taken out of people's pockets is unheard of, the fact that these crimes find their way of sliding under the radar, and the results that leave many people being robbed by the industries set in place to protect them.
Health care fraud is something that is even hard to report being that there is a lack of knowledge amongst the people the crimes are being done to. But this why we need more people speaking out on these white collar crimes because it is not violence that is causing the most deaths, money spent or hardships, it is actually white collar crime if people just did the back work instead of being side tracked.
