What type of fraud involves charging or billing a health care program for services that were not rendered?

The type of fraud that involves charging or billing a health care program for services that were not rendered is known as fictitious services. This term specifically refers to creating false claims for services that did not take place, essentially fabricating the existence of medical treatments or procedures in order to illegally receive payment from healthcare programs.

Fictitious services are a serious issue in healthcare fraud, as they contribute to the overall costs of medical care and can lead to improper utilization of resources. In these schemes, perpetrators typically submit claims for services that were entirely made up, often resulting in financial losses not only for insurance providers but also for patients who may experience increased costs associated with fraud in the healthcare system.

While options like clinical lab schemes, unnecessary services, and billing fraud might relate to healthcare fraud, they refer to different aspects or methods of fraudulent activity. Clinical lab schemes focus specifically on laboratory services; unnecessary services involve billing for treatments that are not medically necessary, which can sometimes overlap with fictitious services but is not limited to completely false claims. Billing fraud is a broader term that encapsulates many fraudulent activities, but it does not specifically denote the act of creating fictitious services. Therefore, fictitious services accurately captures the essence of billing for non-existent treatments in the healthcare context