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There are many different types of fraud in the healthcare system.
For example:
- overbilling or billing for fictitious or unnecessary procedures or drugs
- creating false healthcare businesses, or businesses that do not meet regulatory requirements and therefore are unlawful or illegal, and providing services for which claims are made
- recommending drugs or procedures that are more expensive than other options but provide no or insignificant additional benefit.
- prescribing and billing for an expensive drug but providing a cheaper alternative or, in the worst cases, a counterfeit.
The victims of such frauds are private individuals paying their own bills, insurance companies and state (i.e. taxpayer) funded schemes.
The cost to the taxpayer runs to many millions of dollars in almost all countries where there is a state run scheme.
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