Healthcare Data Analytics

582 Healthcare Data Analytics

The following is an example of a fraud case discovered in Florida:

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Example: Florida Dermatologist Case Since 1997 a doctor in Florida had an arrangement

with a local medical laboratory to increase the lab’s referral business. The doctor sent patients

(covered under the U.S. Federal Medicare insurance pr ogram) to the lab for testing and diagnosis of

skin-related issues. The lab provided an unsig ned pathology report to the doctor for each referral.

The doctor then made it appear that he himself ha d con ducted the tests and charged Med ic are f or

the lab’s work. The doctor was paid by Medicare for these services, which ...