In 2017, the US government recovered $2.4 billion from the healthcare industry as a result of actions under the False Claims Act (FCA), a law that originated in the 1800s with the intent of imposing liability on those that defraud government programs. Over recent decades, healthcare and procurement fraud cases have made up the majority of all FCA actions, according to reporting in Today’s Wound Clinic. Meanwhile, specialist insurance provider CFC Underwriting notes that healthcare providers have been forced to navigate reimbursement guidelines that are challenging and confusing, which has in turn seen the rate of billing errors increase over 30%.
“A lot of modern day healthcare providers are now not sitting in a medical facility – they’ve actually got remote locations and they’re doing things like telemedicine and remote patient monitoring, which is probably going to be the leading reimbursable healthcare service for the next 10 years,” said Timothy Boyce, US healthcare team leader at CFC. “To try and navigate those reimbursement guidelines is exceptionally difficult for some of these companies.”
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