To receive government funding, healthcare providers are required to file claims which catalog payment information, as well as submit specific records to support their claims. If healthcare providers submit claims or records that are falsified or intentionally misleading in an effort to procure unwarranted federal funds, they may be in violation of the False Claims Act.
Healthcare fraud is the most damaging form of government fraud, accounting for more than $60 billion lost taxpayer dollars each year. Despite this substantial figure, the government has no watchdog group in place to contain healthcare fraud and thus relies almost entirely on False Claims Act whistleblowers to recover stolen funds.
What Are Some Examples of Healthcare Fraud?
Listed below are the most common ways in which companies and individuals defraud Medicare and Medicaid annually.
- Billing for services or supplies never provided
- Filing misleading cost reports
- Submitting falsified records
- Offering kickbacks or other illegal bribes
- Marketing drugs or medical devices for non-approved purposes
Why Does Healthcare Fraud Occur?
One of the reasons the federal government is unable to adequately recognize healthcare fraud is because the falsified payment information is hidden underneath medical jargon. Often, healthcare companies will make it seem like certain services were performed or necessary (when, in actuality, neither one nor the other is true) by using medical terms which, to anyone without a medical degree, would seem legitimate. For this reason, whistleblowers in healthcare fraud cases are typically employees of the fraudulent company who are familiar with medical procedures and company practices.
In such cases, it is not unusual for the whistleblower to become concerned about job security and workplace harassment for filing a False Claims Act lawsuit. Fortunately, the law protects whistleblowers from employer retaliation and discrimination of any kind, even offering compensation in the event harassment takes place.
At Morgan and Morgan, not only can we help you file a claim safely and securely, but we can ensure that, as a whistleblower, you are protected to the full extent of the law. To learn more about the False Claims Act and whistleblower protection, simply fill out our free case evaluation to have an attorney review your claim, at no cost to you.