The government is a big target because it is a big payer. Government programs make up about 45% of total healthcare spending and private health insurance only makes up 35%.

Medicaid and HMOs may be at higher risk. We’ve all heard of credit card fraud, so when we get our bills, we check to make sure we recognize all the purchases. If we lose our card or see something odd on the bill, we call the credit card company immediately. When it comes to health insurance, we often don’t act the same way. In healthcare, the person receiving services does not pay for the services. That makes it harder to identify fraud. Whenever the patient does not have to pay any of their medical bill, they have no incentive to look at the bill to make sure it is correct. Medicaid and HMO patients may never see a bill, so they can’t help stop fraud.

Source for healthcare statistics: Kaiser Family Foundation [1]