Top Five Provider Fraud Activities

Top Five Provider Fraud Activities

November 20, 2017

Based on public data from the Office of Inspector General and General Accounting Office, the most common health care provider fraud activities are:

  • Fraudulent billing, duplicate billing, and billing for services not medically needed: 46 percent
  • Falsified claims schemes, which usually involve the use of fake medical personas and identify theft: 25.5 percent
  • Kickbacks: 20 percent
  • Prescribing unnecessary medications: 10.8 percent
  • Upcoding: 2 percent

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