According to the Centers for Medicare and Medicaid Services, the United States spends $2.8 trillion annually on health care. The largest of the government sponsored healthcare plans are the Medicare and Medicaid programs. These two programs provide health care coverage for as many as 95 million Americans at an estimated cost of more than $900 billion. Fraudulent billing, however, has been a major and costly problem for government-sponsored healthcare programs for quite some time. When doctors, hospitals, or other healthcare facilities overcharge or submit false bills to federal government programs, they are defrauding the government and essentially stealing taxpayer dollars.
Types of Healthcare Fraud
Common types of healthcare fraud include the following:
- billing for services that were not provided
- paying kickbacks for patient referrals
- billing for unnecessary services
- falsely billing for a higher-priced treatment than was actually provided
- Falsifying a patient’s diagnosis to justify tests, surgeries or other procedures that aren’t medically necessary
- billing each step of a procedure as if it were a separate procedure
Combating Healthcare Fraud
As a consequence of the losses incurred by government healthcare programs, combating healthcare fraud has been a top priority of the government. The False Claims Act contains provisions that allow “relators” or “whistleblowers” with evidence of fraud against the government to sue on behalf of the government. These people are eligible to receive 15 to 30 percent of the recovery in a successful lawsuit if they have provided original information to the government regarding fraudulent activities. The FCA also protects these whistleblowers from employer retaliation.
If you believe that Medicare or Medicaid fraud may be occurring at your workplace, it is important that you speak with an experienced whistleblower attorney. The whistleblower attorneys at The Lambert Firm will review the information that you have regarding the potential Medicare or Medicaid fraud and help you determine if you should file suit. For more information, please contact The Lambert Firm today.