Healthcare Fraud

THREE BILLION DOLLARS are spent each day on healthcare in the United States, and over four billion healthcare insurance transactions are processed each year. Of these transactions, a small percentage of them are fraudulent. Estimates from the Centers for Medicare and Medicaid Services suggest the healthcare spending will account for 17 percent of the gross domestic product by 2011. When all is said and done, it is estimated that between $39 and $100 billion is lost to fraud and abuse in healthcare each year.

The Springfield, Illinois, division of the Federal Bureau of Investigation (FBI) in 2003 defined healthcare fraud as “knowingly executing or attempting to execute a scheme or artifice to defraud a health benefits or insurance program or the willful execution of a scheme ...