What changed for the Medical Payment Integrity and Fraud Detection Industry

What changed for the Medical Payment Integrity and Fraud Detection Industry

Health care fraud includes "snake oil" marketing, health insurance fraud, drug fraud, and medical fraud. Health insurance fraud occurs when a company or individual defrauds an insurer or a government health program such as Medicare (USA) or equivalent government programs.

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Some of the key players of Medical Payment Integrity and Fraud Detection Industry:

SAS Institute Inc, Context 4 Healthcare Inc, SCIOInspire, Corp, COTIVITI, INC, MultiPlan, Change Healthcare, PLEXIS Healthcare Systems, TransUnion LLC

The way in which this is done varies and individuals who commit fraud are always looking for new ways to circumvent the law. Fraud damage can be remedied through the application of the False Claims Act, most commonly under provisions that reward a person as a "whistleblower" or a relator (law).

The FBI estimates that healthcare fraud costs American taxpayers $ 80 billion annually. Of that amount, US $ 2.5 billion was recovered through False Claims Act cases in fiscal 2010. Most of these cases were filed in accordance with legal requirements. During the 2010 fiscal year, whistleblowers received a total of $ 307,620,401.00 for helping forward the cases.

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