State, Federal Officials Encourage Physicians To Fight Health Care Fraud
California and federal officials are urging physicians to step up efforts to prevent fraud and identity theft in Medicare and Medi-Cal, the Riverside Press-Enterprise reports. Medi-Cal is California's Medicaid program.
Officials discussed ways to prevent fraud during a meeting of medical professionals on Thursday at UC-Riverside.
Discussion of Fraud
Officials said there are a number of ways to commit health care fraud.
For example, a person pretending to represent Medicare could call patients and obtain their personal information, which could be used to obtain treatment or medications or to bill Medicare for services that never were ordered or delivered.
Diane Caradeuc of CMS said medical fraud prevents physicians from being paid. She added that individuals who commit identity theft could prevent patients from receiving care or medical supplies if their health records indicate they already received treatment and services.
Nancy Heard of the California Department of Health Care Services said physicians should be attentive to orders, referrals and prescriptions that they are asked to sign.
She said physicians also should verify billing records for accuracy and require patients to show picture identification with their insurance cards.
Julie Schoen, an attorney for the Council on Aging-Orange County, said physicians should check their provider number to ensure that others have not used it (Hines, Riverside Press-Enterprise, 9/22).
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