WASHINGTON—The Financial Crimes Enforcement Network (FinCEN) is alerting financial institutions to a rise in fraud trends related to the healthcare industry as the coronavirus pandemic continues.
FinCEN outlined 16 red flag indicators to watch for, and provided additional details into submitting suspicious activity reports (SARs) for these frauds.
Of note, the fraud is targeting Medicare, Medicaid and the Children's Health Insurance Program (CHIP), TRICARE, healthcare programs provided through the Veterans Affairs Department, and relief funds provided to healthcare providers through the Paycheck Protection Program and Health Care Enhancement Act.
Types of Activity
The illicit activity includes:
- Unnecessary services
- Billing schemes
- Kickbacks
- Healthcare technology schemes related to COVID-19 testing, treatments, or cures
- Telefraud and telehealth schemes to collect personally identifiable information (PII) and submit fraudulent claims
- Fraudulently obtaining COVID-19 healthcare relief funds
- Identity theft
The 16 red flags are broken out into four sections of types of illicit activity to help financial institutions better identify suspicious activity. FinCEN recommends accessing its other coronavirus-related advisories for activity that doesn't fall into the healthcare industry.