What is an example of health care fraud?

A common example of health care fraud in the UK is claiming payment from the NHS for treatment that was never provided.

For example:

• A healthcare provider submits a claim to the National Health Service for appointments, tests, or procedures that patients never received.
• The provider then receives NHS funding based on those false claims.

Other examples of healthcare fraud include:

• Falsifying patient records to obtain higher payments.
• Charging for more expensive treatments than were actually provided (“upcoding”).
• Using someone else’s NHS details to obtain treatment or prescriptions.
• Obtaining prescription medicines through false information or forged prescriptions.
• Employees submitting false expense claims or stealing NHS funds or equipment.

In the UK, healthcare fraud against the NHS is investigated by the NHS Counter Fraud Authority and can lead to criminal prosecution, fines, and imprisonment.

In simple terms, healthcare fraud is dishonestly obtaining money, services, or benefits from a healthcare system by deception.