Medicaid program runs
jointly by state and federal governments to provide health care services to
individuals with low income and resources. Such program usually covers nursing
home care and personal home care services.
In the past many
years, there has been increase in cases of fraud and abuse in Medicaid
programs. Such fraudulent acts include intentional misrepresentation of facts
and figures to get unauthorized advantage. It also includes medical practices
that unnecessarily increase costs, over utilization of resources and
inaccurate payments for services and much more. However, many times
medical practitioners and health care units are investigated for spurious
charges, which make their business as well as reputation at stake. They may
have to face severe punishments if they are not able to prove their innocence.
Any individual convicted of felony may have to face up to five years in prison
for each felony count in the indictment. He may get suspended from service or
even the professional license gets cancelled by the government.
