Blowing the Whistle on Medicare Fraud the Right Way is Important for a Successful Cash Award

Medicare, which is a federal healthcare insurance program for people older than 65, is funded through a taxes that citizens pay.

In March 2020, the government passed CARES Act that expands Medicare’s ability to cover treatment and services for uncovered individuals affected by COVID-19 who would have qualified for Medicaid if the state had chosen to expand. Other individuals with limited Medicaid coverage are also eligible for coverage under this state option. Though most individuals are honest to their profession, some do cheat the system and resort to fraudulent activities. As a result, the taxpayers’ money lands into the private pocket, and those in need of care are denied it due to lack of funds and resources.

Medicare and Medicaid fraud refers to illegal practices aimed at getting unfairly high payouts from federally-funded healthcare programs. It can be committed by healthcare facilities, program beneficiaries and other stakeholders. The National Healthcare Anti-Fraud Association estimates monies lost to Medicare fraud to be as high as more than $300 billion each year.

There are many activities that can be viewed as fraud. Some actions are taken by doctors, supply chain vendors, while others are taken by program beneficiaries, nurses and other medical specialists.

Common types of fraud against Medicare include:

• Billing for services that were not provided
• Charging separately for services that are usually charged at a package rate (unbundling)
• Incorrectly reporting assets, income and other financial information
• Charging Medicare for a more expensive service than was provided (upcoding)
• Mistreating or abusing patients
• Receiving a bribe or kickback            
• Performing unnecessary tests or giving unnecessary referrals, known as ping-ponging
• Enrolling a beneficiary into a Medicare Advantage plan without their consent
• Filing claims for reimbursements for which the beneficiary is not entitled
• Skimping on the number of pills in the bottle to save money
• Committing identity theft
• Not following Medicare marketing rules
• Selling the Medicare number to someone who bills Medicare for services not received

Medicare fraud not only results in excessive financial losses but also in patient harm. Medicare and Medicaid fraud are a multi-billion dollar drain on the US healthcare system. Detecting and preventing fraud is an important priority for the people and departments that oversee these critical programs. As more funds are needed to provide the necessary care to patients in need, taxes are raised. Thus, every tax paying citizen is affected. The wasted funds could be rightfully used to support participants who really need assistance. So, it is important to report Medicare fraud to maintain the integrity of the US healthcare system.

Solutions to mitigate Medicare fraud and risks

Successful persecution of individuals charged with committing Medicare fraud is essential to deter the fraudulent activity. False Claims Act (FCA) is specially created to combat Medicare and Medicaid fraud. Under FCA, the federal government may sue violations for treble damage, plus $5,500 to $110,000 per false claim.

Medicare whistleblowers may report fraud under Qui Tam provision of the False Claims Act. Under FCA, it is mandatory to engage a Medicare fraud lawyer to file a qui tam case. Brown LLC is the leading whistleblower law firm with some of the best Medicare fraud whistleblower attorneys who can help you with successfully filing a qui tam case against the wrongdoers. As one of the best whistleblower law firms, Brown LLC has helped its whistleblower clients earn tens of millions in claims. The firm’s Medicare fraud lawyers will help you in filing the qui tam case following the right procedure and support it with proper documentation for the best potential outcomes in your favor.

How much could be your cash award amount?

Note that under the FCA provisions, the government can recover up to three times the amount of money obtained through false claims by the fraudsters. So, if you report a Medicare fraud worth $10 million, the government can recover up to $30 million from the wrongdoers. To encourage Medicare fraud reporting, FCA has instituted Medicare whistleblower award which could be up to 25% of the amount the government is able to recover based upon your information. However, if the government does not participate in the investigation due to lack of resources or some other reason, Medicare whistleblower can be awarded anything from 15% to 30% of the total monies recovered. So, if you file your qui tam case through Brown LLC’s best Medicare fraud lawyers who will help you with the documentation and investigation for successful completion of your reporting, you could be entitled to receive up to $10 million as whistleblower award for uncovering a fraud worth $10 million. In addition, you will also be reimbursed your litigation costs.

Putting the best team by your side

Brown LLC whistleblower law firm is headed by a former FBI Special Agent. The law firm is bound by its client privileges, and won’t disclose your information to any third party. Your quit tam case will be filed under seal or anonymously by Brown LLC’s Medicare fraud lawyer. However, you may lose your anonymity at a later stage. Brown LLC won’t charge you anything till you are awarded your whistleblower amount. Moreover, your information will not be shared with anyone if it is not found to be substantial enough for a qui tam lawsuit. Brown LLC’s best whistleblower lawyer will also protect you from retaliatory action by the wrongdoer, such as your former or current employer. For more information, please call Brown LLC‘s whistleblower hotline number (877) 561-0000

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Created on Mar 15th 2021 21:33. Viewed 509 times.

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