Healthcare Fraud

Spending on Government health care programs continues to increase. In addition to Medicare and Medicaid, the Government also funds other state and federal insurance programs. These health care programs cost taxpayers more than $600 billion a year. Although billions of dollars in health care fraud have already been exposed, according to the Federal and State Government, billions of dollars go unaccounted for each year.

Due to the high volume of health care claims submitted on behalf of the millions of Americans insured under these programs, the Government alone cannot effectively combat health care fraud. Whistleblowers are in the best position to detect fraudulent conduct and to bring it to the attention of the Government by filing a qui tam lawsuit on behalf of the Government.

Types of Medicare and Medicaid Fraud include:

• Charging for medical services not provided or not performed;
• Charging for medical services on a patient that does not exist or never received the services billed for;
• Charging for medical supplies not given to the patient or used on the patient;
• Kickback and bribing schemes to obtain Medicare and Medicaid covered patients such as discounted equipment leasing, research grants, referral fees, productivity bonuses, finder’s fees, etc.;
• Misrepresenting the nature of services provided and up-coding the code when submitting the claim to Medicare or Medicaid in order to be reimbursed for a more expensive procedure that was not actually performed;
• Charging an individual separately for services that should have been included in other bills or all inclusive rates;
• Unbundling and billing each procedure or test separately, which otherwise should have been included in a bundled rate;
• Falsifying medical records and necessity of certain procedures;
• Submitting claims for services, treatments, tests, and medical devices that are not medically necessary;
• Submitting false certifications in order to cause a claim to be paid;
• Charging Medicare or Medicaid for devices that have not been approved by the U.S. Food and Drug Administration.

Without the information provided by whistleblowers filing a qui tam claim under the federal and state false claims act, healthcare fraud would go undetected by the government.

If you have any first hand knowledge, information or evidence related to acts of fraud perpetrated against the federal, state, or city government, please contact us for a free and confidential consultation by calling our 24/7 hotline at 212-605-6200 or toll free at 1.888.FRAUD.USA (1.888.372.8387), or by submitting an email inquiry.

The whistleblower attorneys at Levy Phillips and Konigsberg, LLP, have the dedication and resources it takes to successfully prosecute a Qui Tam case. We can protect your rights, fight fraud and obtain the compensation you deserve.

This information is for educational purposes. It is not offered as and does not constitute legal advice or legal opinions. You should not act or rely upon this information without seeking the advice of an attorney.