One of the most common forms of healthcare fraud involves submitting claims to the government for reimbursement for services that were not actually administered to Medicare or Medicaid patients.  Similarly, some healthcare providers create “ghost patients” and bill the government for services for patients who do not exist.  Any submission to Medicare or Medicaid for reimbursement for a service not rendered to a real patient may violate the FCA.

Example

In one of the more brazen violations of the FCA, Intercare Health Systems Inc. (formerly known as City of Angels Medical Center) submitted claims to Medicare for services that were not actually given to patients.  The company paid “recruiters” at Los Angeles homeless shelters to deliver homeless people to hospitals, regardless of whether or not they actually needed medical treatment.  Then, the company billed Medicare for services not actually rendered to the patients, or for those not medically necessary.  The company ultimately agreed to a consent judgment of $10 million for violating the FCA and the Anti-kickback Statute.