healthcare fraud investigations

Healthcare fraud investigations involve examining claims and billing practices to detect and prevent illegal activities, such as submitting false or exaggerated charges for services not provided or unnecessary treatments. Authorities like Medicare and private insurers review patterns, medical records, and billing data to identify suspicious activity. When fraud is suspected, investigators gather evidence, interview involved parties, and may prosecute offenders. These efforts aim to protect resources, ensure compliance, and maintain trust in the healthcare system by preventing financial loss from deceptive practices.