Balance Billing by Contracted Providers
Whistleblower Rewards Network has learned that some healthcare providers who have executed preferred provider contracts with Medicare, Medicaid and insurance companies are billing patients for amounts greater than the agreed upon discounted contract rate. This practice is known as balance billing and it is illegal in many states. In the state of Nevada, to knowingly and willingly file a claim for an amount that is not due and is greater than the contracted billing rate is a violation of the false claims section of the Unfair Trade Practices and Fraud Act, specifically NRS 686A.291.
How to Report Suspected Balance Billing Fraud
If you have reason to believe you are a victim of balance billing, simply click on the link below in red for a free case evaluation. If you believe you have a whistleblower claim simply click on the link below in red for a free case evaluation. Any and all information provided to Whistleblower Rewards Network will be kept strictly confidential and will be for the use of our designated attorneys, our investigating agents and the appropriate state and or federal government agencies. Whistleblower Rewards Network strictly prohibits the dissemination, distribution or copying of your information to any unauthorized outside parties.
Balance Billing Laws Applicable in Alaska
A person who knowingly and with intent to injure or deceive any insurance company, files a statement containing any false, incomplete or misleading information is guilty of a felony.
Balance Billing Laws Applicable in Arizona
For your protection, Arizona law requires the following statement to appear on this form. Any person who knowingly presents a false or fraudulent claim for payment of a loss is subject to criminal and civil penalties.
Balance Billing Laws Applicable in Arkansas
Any person who knowingly and with intent to defraud any insurance company or another person, files a statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact, material thereto, commits a fraudulent insurance act, which is a crime, subject to criminal prosecution and civil penalties.
Balance Billing Laws Applicable in California
For your protection, California law requires the following to appear on this form: It is unlawful to: (a) Present or cause to be presented any false or fraudulent claim for the payment of a loss under a contract of insurance. (b) Prepare, make, or subscribe any writing, with intent to present or use the same, or to allow it to be presented or used in support of any such claim. Every person who violates any provision of this section is punishable to imprisonment in the state prison, or by fine not exceeding one thousand dollars ($1,000), or both.
Balance Billing Laws Applicable in Colorado
It is unlawful to knowingly provide false, incomplete or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, and denial of insurance and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete or misleading facts or information to a policy holder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies.
Balance Billing Laws Applicable in Florida
Any person who knowingly and with the intent to injure, Defraud, or Deceive any Insurance Company, files a Statement of Claim Containing any False, incomplete or Misleading information is Guilty of a Third Degree Felony.
Balance Billing Laws Applicable in Idaho
Any person who knowingly, and with intent to defraud, or deceive any insurance company, files a statement containing any false, incomplete or misleading information is guilty of a felony.
Balance Billing Laws Applicable in Indiana
A person who knowingly and with intent to defraud an insurer files a statement of claim containing any false, incomplete, or misleading information commits a felony.
Balance Billing Laws Applicable in Kentucky
Any person who knowingly and with intent to defraud any insurance company or other person files a statement of claim containing any materially false information or conceals, or the purpose of misleading, information concerning any fact material thereto commits fraudulent insurance act, which is a crime.
Balance Billing Laws Applicable in Maine
It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include imprisonment, fines or a denial of insurance benefits.
Balance Billing Laws Applicable in Michigan
Any person who knowingly and with intent to defraud any insurance company or another person, files a statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact, material thereto, commits a fraudulent insurance act, which is a crime, subject to criminal prosecution and civil penalties.
Balance Billing Laws Applicable in Minnesota
A person who submits an application or files a claim with intent to defraud or helps to commit a fraud against an insurer is guilty of a crime.
Balance Billing Laws Applicable in Nevada
Pursuant to NRS 686A.291, any person who knowingly and willfully files a statement of claim that contains any false, incomplete or misleading information concerning a material fact is guilty of a felony.
Balance Billing Laws Applicable in New Hampshire
Any person who, with purpose to injure, defraud or deceive any insurance company, files a statement of claim containing any false, incomplete or misleading information is subject to prosecution and punishment for insurance fraud, as provided in RSA 638:20.
Balance Billing Laws Applicable in New Mexico
Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to civil fines and criminal penalties.
Balance Billing Laws Applicable in New Jersey
Any person who knowingly and with intent to defraud any insurance company or other persons, files a statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact, material thereto, commits a fraudulent insurance act, which is a crime, subject to criminal prosecution and civil penalties.
Balance Billing Laws Applicable in New York
Any person who knowingly and with intent to defraud any insurance company or other persons, files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation.
Balance Billing Laws Applicable in Ohio
Any person who, with intent to defraud or knowing that he/she is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.
Balance Billing Laws Applicable in Oklahoma
Any person who knowingly and with the intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony.
Balance Billing Laws Applicable in Oregon
Any person who makes an intentional misstatement that is material to the risk may be found guilty of insurance fraud by a court of law.
Balance Billing Laws Applicable in Pennsylvania
Any person who knowingly and with intent to injure or defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.
Balance Billing Laws Applicable in Virginia
It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment, fines and denial of insurance benefits.
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