Targeting health care fraud

The FBI is combating health care fraud. Some of the big scams out there right now are involving home health care, infusion therapy (when treatment is inserted directly into blood, muscle or the spinal cord), and double medical equipment billing.

Another big scam the agents are targeting: off-label marketing of prescription drugs. The practice involves a drug maker promoting their product for other uses not approved by the FDA and sometimes in larger doses than the FDA allows. This act is not only illegal but also potentially harmful to consumers.

The FBI warns that as the cost of health care expands ($2.26 trillion by 2016), so does the opportunity for fraud. The FBI teams up with other federal agencies like the FDA, the DEA and the Health Care Fraud Prevention and Enforcement Action Team, or "HEAT"-- which is part of the Department of Justice and Health and Human Services, to combat the issue. HEAT looks for possible fraudulent activity in billing patterns by health care providers.

What the FBI has to say about health care fraud:

* Health care fraud schemes come in all forms-fraudulent billings, medically unnecessary services or prescriptions, kickbacks, duplicate claims, etc.

* Schemes target large health care programs-both public and private-as well as health care beneficiaries. (Medicare and the Medicaid are the largest programs, so they are targeted more often.)

* Schemes are committed by health care providers, owners of medical facilities and laboratories, suppliers of medical equipment, organized crime groups, corporations, and even sometimes by the beneficiaries themselves.

* FBI health care fraud cases sometimes cross over into other investigative areas, like organized crime, gangs, and cyber crime, where we see criminals beginning to use the proceeds from health care fraud schemes to fund their operations.

Tips to help avoid being victimized:

* Protect your health insurance information card like a credit card.

* Beware of free health services-are they too good to be true?

* Review your medical bills, like your "explanation of benefits," after receiving health care services and ensure the dates are services are correct.

And if you suspect health care fraud, contact your local FBI office.