If you are one of the Medicaid Service Providers, here are a few reasons that can trigger Medicaid Investigations Las Vegas:
- Falsifying the patients’ diagnosis to justify the tests or any other procedure that are not medically necessary;
- Billing the Medicaid for the services that hasn’t ever been provided;
- Misrepresenting the procedures performed in order to obtain payments for the non-covered health care services;
- Upcoding: it relates to billing for more costly services than ones that were actually performed;
- Unbundling: it relates to billing each and every stage of a given procedure as if it was a separate procedure;
- Filing Medicaid claims for staged and fake car accidents in Las Vegas;
- Filing Medicaid claims for fake healthcare services and for fake medical conditions;
- Filing Medicaid claims for any non-existent illness;
- Illegal fee sharing;
- Billing for health care services provided by any unlicensed personnel that is in violation of the Medicaid rules;
- Illegal kickbacks.
Medicaid investigations and prosecutions can be duly conducted on the federal and state levels, suggests Healthcare Attorney LasVegas.
On the federal level, one can deal with the FBI, or the Office of Inspector General, and any other federal law enforcement agency.
On the state level, Medicaid fraud care are often handled by various organizations including:
- Local district attorneys
- The Office of Medicaid Inspector-General
- The Medicaid Frauds Control Unit – Las Vegas Attorney General’s Office
Once your practice is flagged for Medicaid fraud, the investigation will duly begin and it could continue for several months or even for years.
