Blow the Whistle on Medicare Fraud to Potentially Receive a Whistleblower Award

by Brown LLC Whistleblower Law Firm,Class Actions and Injury La

is thought that tens of billions of dollars a year or about ten percent of all healthcare spending in the USA results from the submission of false claims to government healthcare programs such as Medicaid and Medicare and each year through the False Claims Act and a skilled whistleblower attorney, billions of dollars are recovered.  Whistleblowers improve the system, hold entities accountable, and can receive whistleblower awards up to 30% of the government recovery.  With roughly $3 billion a year recovered, that’s close to a billion dollars a year for whistleblowers.

Medicaid and Medicare frauds are committed by all sorts of entities, but commonly committed by managed care organizations, pharmacies, hospitals, skilled nursing facilities, medical devices and durable medical equipment manufacturers and distributors, and laboratories and diagnostic testing facilities. Some of the ways in which people cheat the healthcare system include:


  • Violating the laws that prohibit kickbacks and certain financial arrangements
  • Risk adjustment fraud in which only escalated payments are made to promote providers  only servicing individuals with costly diseases
  • Exaggerating the time, procedure and healthcare staff involved in treatment (Upcoding)
  • Billing a single service as if it were multiple services
  • Billing for services that are medically not required
  • Billing for services not provided at all
  • Off label marketing of prescription drugs
  • Fraudulently claiming electronic health record (EHR) by improperly increasing reimbursements
  • Pharmacies charging Medicare and Medicaid for brand name drugs while filling prescriptions with generic medicines


Whistleblowers, with insights about systemic fraud happening in their organization, play a crucial role in protecting the integrity of the healthcare system and also saving the American taxpayers’ money. An employee, doctor, clerk, accountant, supplier, vendor, a private citizen or even a competitor with substantial information about the fraud could be a whistleblower.

Potentially receive a reward for reporting fraud at the workplace

Whistleblowers reporting Medicare fraud or Medicaid fraud under the False Claims Act (FCA) can receive anything from 15% to 30% of the share of the government’s recovery as a financial reward on recognition of their courage to save the U.S. taxpayers’ money and ensuring the integrity of the government’s healthcare programs. However, you should consult a Medicare fraud lawyer before filing a lawsuit as merely a suspicion is not enough, the whistleblower law firm can evaluate whether you have enough information what is need to put the case forward with the government to show your employer is committing fraud.

Whistleblower laws are on your side – you are protected

The law is on the side of the whistleblowers reporting Medicare fraud with insights about the fraud and financial irregularities. A Medicare fraud lawyer will ensure that you are protected from retaliatory action by your employer for reporting Medicare fraud. This protection also extends to a contractor or agents and covers processes of investigating whether or not fraud had occurred. If you are suspended, demoted, threatened or otherwise discriminated against for being a whistleblower you  will have the standing to sue your employer for the retaliation. A whistleblower is entitled to recover damages from their employer for the losses actually sustained, and also compensation for the pain and suffering due to the alleged emotional stress.  The whistleblower is protected in many different ways and some of the best whistleblower attorneys can tell you based on experience what to expect and how your identity is generally shielded from the employer for several years so you have time to look for a parachute.

Each individual defrauded invoice submitted to a Medicare or Medicaid program constitutes a separate false claim. The FCA allows the government to recover three times the amount of the false claim submitted, and also a penalty of $5,000 to $20,000, or even more, depending upon when the penalties are awarded, and adjusted for inflation. Fraudulent practices can involve false claims for thousands, and sometimes millions of patient claims, making the amount in civil penalties in Medicare fraud cases potentially staggering. 

Consult an experienced Medicare whistleblower lawyer

However, potential whistleblowers should consult the best whistleblower attorney who will provide them with the guidance to blow the whistle the right way. If you believe that a Medicare or Medicaid fraud has occurred at your workplace, you should speak to a Medicare fraud lawyer who may review the information you have and help you determine should a whistleblower lawsuit or Qui Tam claim be filed.

Brown LLC, a premiere whistleblower law firm has some of the best whistleblower attorneys with millions upon millions in recoveries for whistleblower actions and in excess of hundreds of millions recovered in all its lawsuits.

You can request a free consultation with Brown LLC’s best whistleblower attorneys by filling a quick online form at and a lawyer  from this experienced and accomplished qui tam law firm will contact you to help you blow the whistle the right way if the case is actionable and try to obtain the maximum compensation for your courage. The best whistleblower attorney at Brown LLC will help maintain your confidentiality during the whistleblowing process, and also help protect you from retaliation by your employer.

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Created on Jan 7th 2021 23:27. Viewed 740 times.


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