Which action exemplifies a multiple claims health care fraud scheme?

Prepare for the ACFE Certified Fraud Examiner (CFE) Financial Transactions and Fraud Schemes Test with our comprehensive quiz. Engage with flashcards, multiple choice questions, hints, and explanations. Ace your exam!

A multiple claims health care fraud scheme involves submitting claims for the same medical service to different insurance providers. This practice is fraudulent as it seeks to obtain payment multiple times for the same service, effectively defrauding insurers by exploiting the system. Each submission for reimbursement constitutes a separate act of fraud, leading to unjust profits for the claimant at the expense of the insurance providers.

In contrast, the other options represent different forms of health care fraud. Using an ex-spouse's health insurance is a form of identity or coverage misrepresentation but does not necessarily involve multiple claims for the same service. Impersonating someone else to obtain medical care also focuses on misrepresentation, specifically concerning identity rather than claiming the same service multiple times. Filing claims for services that were never rendered involves fraudulent claims based on nonexistent services, which is a different type of fraud. Each of these scenarios involves deceit, but only submitting claims for the same service to multiple insurers qualifies specifically as a multiple claims scheme.

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