FinCEN Warns Of Health Insurance And Healthcare Fraud Related To COVID-19

The Financial Crimes Enforcement Center (FinCEN) has issued an advisory against new scams involving healthcare or health insurance during the pandemic.

The frauds have been targeting “Medicare, Medicaid/Children’s Health Insurance Program (CHIP), and TRICARE as well as health care programs provided through the Departments of Labor and Veterans Affairs (collectively, ‘health care benefit programs’) and private health insurance companies,” the report says.

The government has also seen fraud targeting COVID-19 relief funds for health care providers, like those in the Paycheck Protection Program (PPP) and the Healthcare Enhancement Act.

The report goes on to list several types of unsavory activities that could signal fraud. One is offers of unnecessary services, such as ordering of expensive tests or services that don’t have anything to do with COVID-19. They’re often done in conjunction with testing for the virus, the report says, and could include things like respiratory testing, genetic testing, or whole-body health assessments.

Another is billing schemes for services not provided or overbilling, and other scams could involve kickbacks or bribes.

Then there are health care technology schemes, FinCEN writes, which could constitute fraudulent responses about testing, treatment or cures. And, FinCEN writes that still more types of fraud could involve telehealth scams to steal peoples’ information, false claim applications for federal relief funds, or identity fraud intended to help the fraudsters commit scams against health care benefit programs.

The pandemic has been bountiful for fraudsters, who began taking advantage of the country almost immediately after lockdowns began, reveling in the confusion and chaos of trying to switch to digital modes of working and living.

PYMNTS reports that there has been a particular rash of cyberattacks targeting hospitals and health care agencies. Charles Carmakal, chief technical officer of the cybersecurity firm Mandiant, said there had been a surge of them last fall that was the “most significant cybersecurity threat” the U.S. had ever seen. Now, a new wave is targeting the agencies again as vaccines are being rolled out.