Nurses, Certified Nurse Aids, Rehab Therapists and even the Directors of Nursing at home healthcare companies may be the first to notice when something is wrong in the way a home healthcare business operates. Upcoding for services that result in a higher reimbursement rate from the government is common in home healthcare and healthcare fraud. Another indicator of fraud is payment of kickbacks to referring positions, which is not only a STARK violations, but likely an indicator of referrals for unnecessary medical services.