The United States Sentencing Commission reported 431 healthcare fraud offenders in the fiscal year 2022. This growing problem encompasses a range of different tactics used by professionals within the industry to get money through fraudulent means.
One common scam is unnecessary procedures or services. This kind of fraud occurs when medical professionals recommend and perform treatments, tests or procedures that are not medically necessary.
Motivations behind the fraud
Sometimes, financial greed may motivate a medical professional to commit fraud. In other cases, a doctor might be overly cautious or even influenced by incentives tied to certain procedures.
Types of unnecessary procedures or services
One common example of this type of fraud is the overuse of medical tests. Imagine a scenario where your symptoms suggest a minor ailment, yet the doctor orders a battery of expensive tests that do not provide additional insight. This not only wastes time and resources but also exposes you to potential risks associated with unnecessary procedures.
Invasive procedures, such as surgeries, are not exempt from this fraud either. Undergoing surgery without a clear medical need means you face the potential complications and risks of that procedure and also you have to go through a prolonged recovery process.
Protecting yourself
It is essential to ask questions. Do not hesitate to inquire about the necessity of a recommended test or procedure. Seek a second opinion if something feels off or if you are unsure about a proposed course of action. Furthermore, you can educate yourself about your medical conditions and potential treatments. This knowledge empowers you to make informed decisions about your health.
Unnecessary procedures or services healthcare fraud is a breach of trust that endangers both patient well-being and healthcare integrity. You must be proactive to ensure that any medical care you receive is for a genuine medical need.
