upcoding and unbundling; healthcare fraud

What Are Upcoding and Unbundling?

Health care fraud occurs when a medical provider intentionally submits false or misleading information for use in determining the amount of health care benefits payable. Upcoding and unbundling are forms of health care fraud. At times, innocent health care providers can be routinely accused of upcoding, unbundling, and other forms of health...

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healthcare fraud

Penalties of Health Care Fraud

Penalties for health care fraud violations can range in type and severity. Over the last several years, the federal government has been aggressively cracking down on health care fraud. Health care fraud is a type of crime that involves the filing of dishonest health care claims. Anyone who is convicted of health...

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health care worker

Common Types of Health Care Fraud

Health care fraud can take many forms, but there are common types of health care fraud schemes frequently prosecuted by the Department of Justice (“DOJ”). It is also a frequent subject of False Claims Act (“FCA”) qui tam suits. FCA actions have resulted in the recovery of billions of dollars on...

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