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Medicare and Medicaid Fraud Reporting: 5 Things You Need To Know

  • March 29, 2015

Medicaid fraud reporting can result in your reward. Following are several things to keep an eye out for.

1. Medicaid and Medicare fraud happen on a very broad scale. Medicare is a health insurance program that is funded by the government and which provides 46 million disabled and elderly Americans with health care. Each year the government pays out Medicare benefits of almost half a trillion dollars. Unfortunately, numerous unethical individuals have found a variety of ways to steal these public monies and as a result of this the government now pays out approximately $60 billion annually in fraudulent Medicare claims.

2. There is a vast number of ways in which people commit Medicaid and Medicare fraud. Some examples of these fraudulent activities include charging for supplies and services that have not been rendered, unnecessary billing for services, making generic drug substitutions, double billing, kickbacks and a host of additional billings that are unauthorized.

3. You can take part in the fight against these crimes by assisting in Medicare and Medicaid fraud reporting. It is vital for recipients of Medicaid and Medicare to review their invoices to determine whether or not these billings include supplies and services that have not be rendered. When receiving health care services, it is always best to write down the calendar dates of services and to retain copies of statements and receipts that health care providers issue you in order to make certain that billing errors are not present. You can make comparisons of these documents to the Medicare and Medicaid statements you have received. This ultimately ensures that neither Medicaid nor you have been billed for supplies and services that were not remitted.

4. Medicare and Medicaid fraud reporting could lead to you becoming the recipient of an award. The False Claims Act (Sections 3729 of 31 U.S.C) allows for incentives for “whistleblowing” in order to encourage Medicaid fraud reporting from private recipients. This Act additionally enables people who know of current or past incidents of Medicaid fraud to take legal action on behalf of the state government in order to recover damages and civil penalties. These “whistleblower” incentives allow for the award of up to 30% of the proceeds that are recovered.

5. Medicare and Medicaid fraud reporting is the specialty of PHMY attorneys, as are whistleblower lawsuits. Our attorneys can successfully manage your whistleblower lawsuit from its beginning to its end. We are aware of how and where to file such claims and have a vast number of federal contacts for the effective prosecution of your case. Fighting fraudulent Medicaid claims is what we do and we are ready to invest the resources and time that is necessary for winning your whistleblower case.

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