The federal government and many states are cracking down on radiology clinics that falsely bill Medicare and Medicaid for unnecessary services, inflate their billings or pay kickbacks to physicians and medical staff that refer patients.

Medicare fraud is a growing problem in the United States. The FBI estimates that tens of billions of dollars are lost annually because of healthcare fraud. Because Medicaid, Medicare and Tricare are paid with tax dollars, whistleblower awards are available for those who come forward with inside information about illegal activity.

Common illegal schemes that may make you eligible for an award include:

• KICKBACKS: The federal Anti-Kickback Statute prohibits the exchange of anything of value made to induce or reward the referral of taxpayer funded healthcare business.Common examples include cash payments, gift cards, trips, free or discounted rent deals, tickets to sporting events and the like. It is also generally illegal for a physician to refer a patient to an entity which the physician or immediate family member owns.
• OVERBILLING (sometimes called “Upcoding”)
• BILLING for MEDICALLY UNNECESSARY SERVICES
• BILLING for SERVICES NOT PROVIDED
• PROVIDING CERTAIN SERVICES WITHOUT A PHYSICIAN PRESENT
• BILLING MEDICARE for CHIROPRACTIC REFERRALS

The cost of imaging and X-Ray machines is exorbitant. With so many MRI and radiology clinics opening nationwide and competition fierce, many physicians and clinic operators are cutting corners. Although paying for referrals or giving gift cards to patients may seem like an acceptable practice, it leads to unnecessary services and drives up the cost of healthcare for everyone.Whistleblowers represent the government’s first line of defense against fraud and greed. Each year whistleblowers help save taxpayers billions of dollars. In the case of unnecessary medical services or performing certain tests without a physician present, whistleblowers may even save lives and prevent suffering.The U.S. Department of Justice paid out over $435 million in awards in 2014. Whistleblowers affiliated with radiology groups recently received awards of $2.3 million and $1.7 million. Present or former workers in MRI and radiology clinics, physicians and other with inside knowledge of healthcare fraud may be entitled to an award.