As home healthcare picks up the pace, fraudsters find more ways to steal from unsuspecting victims. Whether it is billing Medicare for services not rendered or giving kickbacks illegally, home health care fraud is a punishable crime.
Home healthcare is now more popular than ever before. If the Bureau of Labor Statistics (BLS) predictions are anything to go by, there will be a 48% increase in the demand for home aides between 2012 and 2022. Many people are shying away from taking their aged relatives to nursing homes. Patients with cerebral palsy, Alzheimer’s disease, and diabetes are now assigned home aides to take care of them at home.
While this arrangement is convenient for many people, it is a breeding ground for fraudsters. The limited information available for in-home care makes it ideal for healthcare fraud. In addition, the industry lacks strict regulations, offers minimal training for workers, and features low wages. In this article, we seek to debunk some of the myths surrounding home healthcare fraud so you can be well informed.
- Home healthcare fraud is easy to execute
Taking advantage of really sick and vulnerable people should be quite straightforward, right? Wrong. Home care agencies often collaborate with doctors and other healthcare officials to execute huge fraud schemes. Often, the agencies offer kickbacks and bribes to doctor’s offices to prescribe home health services and medical certifications. The conspirators, in turn, use these to bill insurance companies fraudulently. In other instances, the fraudsters go as far as signing up persons who don’t necessarily need home-care services. These can be homeless people with Medi-Cal and Medicare beneficiaries. In short, it takes a lot to pull a home healthcare fraud.
- Close family members make honest home-aides
Many people imagine that the chances of a close relative home aid abusing the sick or elderly are considerably low. This is actually true for the most part. However, there are a few instances where it’s not. A good example is the case of a homeless Californian woman who convinced her mother to request home health care. In the beginning, she used her mother’s Social Security money to take care of her personal bills. Meanwhile, she only took her sick mother to see the doctor once over a two-year period. After a while, she applied to be her mom’s home aide for which she received $900 every month. Needless to say, she happily pocketed the cash without offering any help to her sick mother. Not long after, her mother passed away from neglect and a severe bedsore. She’s now behind bars for the crime committed. The bottom line: close family members are capable of home healthcare fraud as well.
- Home healthcare fraudsters are not serious criminals
To many people, proper criminals are perpetrators of such crimes as drug and human trafficking, domestic violence, murder, and robbery. These are the people who suffer greatly for their wrongdoings. Insurance fraud is thought to be less serious and therefore carries more lenient punishments. This couldn’t be further from the truth. Anyone caught in the middle of home care insurance fraud will face serious consequences. Their jobs may be compromised or brought to an end altogether. They might have a hard time getting access to insurance and other essential financial services. If the individual pleads guilty to a massive crime, they face the risk of going to jail.
- The police respond slowly to home healthcare fraud
Another common myth about home healthcare fraud is that the police are slow in acting on it. The reason for this is that the regulations are still few and the loopholes many. This makes it hard to nail down the perpetrators and bring them to task. The fact is that the police are always willing to put a stop to insurance fraud of any kind. Some countries such as the United Kingdom even have a special unit within the police force that tackles insurance fraud. The next time you detect home healthcare fraud, don’t be afraid to step up and blow the whistle.
- It is hard to detect fraudulent insurance claims
The notion that fraudulent insurance claims are hard to detect is another myth that needs to be debunked. The truth is that responsible insurers have put the necessary measures to detect, stop, and prosecute fraudsters who try to fabricate a claim. They have become effective at sharing information and sharing intelligence to combat fraud. Big data has come in handy during the process as well.
As home healthcare picks up the pace, fraudsters find more ways to steal from unsuspecting victims. Whether it is billing Medicare for services not rendered or giving kickbacks illegally, home health care fraud is a punishable crime. Don’t participate in it, be a whistleblower, and stay alert always.