Health Insurance Fraud Hurts Insurers, Patients, Columnist Says
Medical insurance fraud hurts both insurers and patients, as insurers spend time and money investigating fraudulent claims and patients might end up being denied or paying more for health coverage because of false information on medical records, Trudy Lieberman writes in a Los Angeles Times Health Matters column. Lieberman notes that a study appearing in the Journal of the American Medical Association in 2000 found 39% of physicians "exaggerated the severity" of a patient's medical condition, reported symptoms that patients did not have or changed an "official diagnosis." Such information ends up on patients' records, and as a result, they could end up paying more for or be denied health insurance. Such "questionable billing practices" also "cost the health system plenty," Lieberman writes. According to Lieberman, government and law enforcement agencies report that health fraud accounts for as much as 10% of the $130 billion the nation spends on health care each year. She concludes, "[W]e all pay for this, whether through higher medical premiums or increased taxes to pay for law enforcement" (Lieberman, Los Angeles Times, 12/16).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.