The FBI has plenary authority to investigate all health care fraud cases. The General Accounting Office estimates that health care fraud waste and abuse may account for as much as ten percent of all health care expenditures. While most health care providers are honest and concerned with the welfare of their patients, significant numbers of unscrupulous persons and companies scheme to defraud our nation's health care programs.
Criminal perpetrators range from individual physicians to national, publicly-traded companies.
Fraud is found in a variety of health care related businesses from medical equipment dealers and suppliers to ambulance companies, laboratories, hospitals, nursing homes, and health care agencies. Health care fraud schemes can be simple or complex. Suppliers may pay kickbacks in the form of money or other inducements. Kickbacks are illegal when paid or received in connection with the provision of goods or services covered by most federal health insurance programs. Fraud on private insurers may also be established if false statements are made to the insurer concerning the true price of the goods or services rendered in order to conceal the inclusion of the kickback cost in the price of the item or service.