Copyright held by The John Cooke Fraud Report. Reprint rights are granted with attribution to The John Cooke Fraud Report with a link to this website.
While the vast majority of health care providers are honest, health care is a big business; and big business without regulatory and legal controls may set the stage for fraud. At a time when health costs are rising relentlessly, it makes little sense to send a message of weakened resolve to voracious providers. New health care fraud schemes and new twists to old schemes are being documented every day. Medicaid Fraud Control Units (MFCU) targeting potential suspects would regard an allegation that a provider had stolen $100,000 from a private insurance payer or from Medicare as an indicator of potential Medicaid fraud.
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