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Medicare Fraud Overview
Medicare fraud is committed when a healthcare provider gives false information to the government to receive Medicare pay for medical care or services that don’t truly qualify for Medicare reimbursement.
Types of Medicare Fraud
There are many different types of Medicare fraud. The most common types of Medicare fraud include billing for unnecessary procedures and tests (or procedures and tests that were never performed) and billing for unnecessary equipment.
A healthcare provider may bill Medicare for services or items that were not actually provided. Medicare fraud also encapsulates something called upcoding, or billing for services at a higher level than those that were actually provided. Drug diversion (writing unnecessary prescriptions or altering existing ones to obtain drugs) and kickbacks (exchanging beneficiary referrals for medical services or items) are both considered Medicare fraud as well.
Medicare fraud can be committed by hospitals, physicians, clinics, pharmacies, labs, dentists, medical product or medical device providers, ambulance companies, and more that bill the government’s Medicare program for medical products or services.
Medicare Fraud Lawsuits
Many Medicare fraud lawsuits have been filed, leading to the recovery of billions of dollars from companies involved in defrauding the government. Whistleblower lawsuits are one of the most powerful ways to call out fraud against the government and recover losses. The False Claims Act puts this power in the hands of private individuals, usually employees of the company at issue, who have evidence of fraud.
Whistleblower Lawsuits
A whistleblower is someone who witnesses some kind of fraud against the government, generally at their place of work, and “blows the whistle” on the scenario by filing a qui tam (whistleblower) lawsuit under the False Claims Act.
When a whistleblower lawsuit is filed, the lawsuit is sent directly to the Justice Department, and are kept confidential as the government determines if it is going to join the lawsuit.
Generally, those who act as whistleblowers and bring Medicare fraud or other fraud to the attention of the federal government receive a substantial whistleblower award of between 15 and 30 percent of any settlement or award money. Government fraud lawsuits can lead to large settlements, so whistleblowers have received between $75,000 and more than $50 million.
Protection from Retaliation
In many cases, those who are considering blowing the whistle on the company they work for are worried about potential retaliation such as being fired, demoted, or harassed for acting as a whistleblower. However, there are anti-retaliation laws in place to protect whistleblowers in these scenarios.
Filing a Whistleblower Lawsuit Over Medicare Fraud
If you have witnessed some kind of Medicare fraud against the government, you may be able to file a whistleblower lawsuit on behalf of the federal government. Filing a whistleblower lawsuit can feel daunting, so Top Class Actions has done the work of connecting you with an experienced Medicare fraud attorney.
Contacting a Medicare fraud attorney can help you determine if you have a case, navigate the complexities of litigation, and maximize your potential compensation.
