Health Care Fraud

By: Nastassja Waller

Health Care Fraud

The intentional act of deceiving, concealing, or
misrepresenting information that results in health
care benefits being paid to a individual or group.
Medical or drug providers can commit health care
fraud.

How does this affect

society?
Health care fraud costs the country tens of billions
of dollars a year. Its rising threat, with national
health care expenditures was estimated to exceed $3
trillion in 2014 and spending continuing to outpace
inflation.

What is being done to prevent

it?
The FBI is the primary agency for exposing and
investigating health care fraud, with jurisdiction over
both federal and private insurance programs. Their
seeking to identify and pursue investigations against
the most egregious offenders. Field officers
proactively target fraud through coordinated
initiatives, task forces and strikes teams, and
undercover operations.

Famous case, and the punishment

Los Angeles-Area Pharmacist Pleads Guilty in Medicare
Part D Fraud Scheme
Rouzbeth Javeherian 34, of Beverly Grove, California,
pleaded guilty to health care fraud in connection with a
scheme to defraud the Medicare Part D program
through a pharmacy called Emoonah Inc. From January
2008 to November 2014, Javaherian received
approximately $644,060 in overpayments from
Medicare as the result of the fraud scheme.