In modern day America, it seems like everywhere you turn people are experiencing financial difficulties. The economic maelstrom has put individuals in a position where they need to get money at any cost. People tend to create scams to loot cash from another person’s pocket like a beggar asks for money from passers-by. The problem is, these fraudulent individuals are not asking, they’re devising a plan to cheat some money out from insurers through falsified claims.

Health insurance fraud is more common than one might like to think. Medicaid estimates that the United States loses about $179 billion a year from health insurance fraud. Many of these claims are considered fraudulent due to “exaggerated claims”, take for instance the Liebeck v McDonalds case in 1994. The 79 year old Stella Liebeck, was burned by a hot cup of coffee she ordered from McDonalds. After undergoing 2 years of skin graft treatment, she sued McDonalds for $2.8 million by stating the coffee was “too hot“ and “she did not know it was that hot“. While McDonalds was found guilty in this case, it made way for many of the modern age precautions restaurants take when serving food and/or drinks. Now McDonalds, and many other restaurants, are required to print caution warnings on cup labels and list food ingredients in dishes to avoid similar cases from occurring. It was an exaggerated claim though it was beneficial to customers as well.

Here are other samples of health Insurance fraud:

“Columbia/HCA Healthcare has agreed to pay at least $754 million after over billing taxpayer-funded Medicare for years. If the deal stands, it will be the largest healthcare fraud settlement in U.S. history. The chain (now named HCA) billed Medicare for unneeded lab tests, improper diagnoses to make patients seem sicker than they were, and disguising unreimbursable expenses as reimbursable. Criminal charges still are pending.”

”Massachusetts orthopedic surgeon Harold Goodman routinely gave patients potentially harmful X-rays and steroid injections they didn’t need so he could falsely bill Medicaid. Goodman spent as few as five minutes with each patient, giving one patient 74 X-rays and 112 steroid injections in less than three years. Goodman received six months in prison in 2000.”

One must have morals when it comes to going about getting money. Times are getting tough but remember, they’re tough for everyone (not just you) and we need to come together instead of pulling each other down. Insurers are trying to minimize these scams together with government agencies. Particular establishments were made to protect the insurers as well as policyholders from deceptive claims. These independent entities have addressed many attempts at fraud, but not all have been successfully debunked and these seem to remain as ongoing trials.