Medical Fraud in India
Medical fraud differs from other kinds of white-collar crime in that it can cause irreparable physical harm to the victim, as opposed to mere financial losses. Due to tax regulations and a lack of stringent application of even those, many unqualified people lie about their credentials, in an attempt to dupe innocent patients. Because these quacks often lack basic medical training, their actions usually have disastrous, sometimes fatal, results.
Over the years, the frauds committed by healthcare facilities, institutions and providers are becoming extremely challenging. Every year, insurance companies in the US lose several thousand dollars to medical fraud. According to the assessment done by the Affordable Care Act (ACA), between 2015 and 2021 healthcare spending is expected to grow at a rate of 6.2% per annum.
According to a World Health Organization report on the state of healthcare in India among allopathic doctors, as many as 31.4% of the claimed doctors were discovered to have been educated only up to a secondary level. In fact, an astounding 57.3% did not possess any medical degree whatsoever. The statistics among dentists were even more damning, with 46.2% of all urban and just 27.4 of all rural dentists having the minimum legal qualifications to practice their profession. These numbers alone are indicative that a significant portion of medical practitioners in India are committing fraud in broad daylight, risking people’s personal safety and severely impacting the integrity of this noble profession. To weed out quacks, frauds, and unscrupulous doctors, it is necessary to take effective counter measures, especially given the fact that millions of lives at risk.
How health care fraud works?
Just like any other industry, fraudulent claims have their significant share even in the healthcare sector. Fraudsters are busy finding means and opportunities to make some undue profit. However, the huge, inviting, easy pile of cash sets healthcare apart from the rest of the industries when it comes to fraud. Some of the major factors that make medical frauds so alluring include –
- The ease in filing fraudulent healthcare claims
- Billing for higher medical codes and incorrect diagnoses which easily go unnoticed
- Lucrative kickbacks for member referrals
- Difficult-to-detect prescription of unnecessary or additional treatments
- The ease of forging and selling prescription drugs
- With insurance and other policies becoming increasingly popular, healthcare crooks can be anyone, including the patients, suppliers, vendors, providers as well as pharmacists. In addition, computer hackers and organized crime rings also add up to this list of fraudsters.
How can you Prevent Healthcare Fraud?
The best solution to this problem is to deploy vast on-field strength and technological capabilities to create a data repository of verified doctors. This can be achieved by
- Visiting each doctor on the ground to register their biometric details along with copies of their medical degrees.
- Authenticating these degrees and certificates at source, which means cross verified with the college/university along with the doctors’ residency details.
- Genuine doctors’ data is then uploaded to the repository creating a master list of medical professionals in a variety of fields and specializations.
- Data of fake doctors also be uploaded so patients can be fairly warned
- Government stores this repository on online and offline public domains, freely available to the public.
Fake doctor in India infects 21 people with HIV
An Indian health official says a fake doctor treating poor villagers for colds, coughs and diarrhea has infected at least 21 of them with HIV by using contaminated syringes and needles.
An investigation showed that almost all of them had taken injections from one person, A special medical camps in villages in the area and checked 566 people, and 21 were found to be HIV positive.
Many villagers relied on Yadav for treatment of common ailments in the area. Villagers said they rarely saw him changing the needles. This probably caused HIV infections.
He said villagers complained that Yadav would give injections for almost all ailments and charged very small fees.
Millions of villagers in India’s remote rural areas depend on fake doctors for cheap treatment for want of doctors and medical facilities in those areas.
FundsTiger is an Online Lending Marketplace where you can search for and avail Fast and Easy loans from almost all the leading Banks and NBFCs. You can Apply for Loans with Best possible Rates of Interest and terms for Personal Loan, Business Loan , Home Loan and Car Refinance Loan.