Medicare fraud is one of the most profitable crimes in America. It costs taxpayers an estimated $60 billion each year.
Medicare fraud cases are complex. They involve constantly changing laws and regulations governing Medicare.
Proving Medicare fraud for whistleblowers is highly technical. It involves strict rules of secrecy that most people do not know about.
Medicare fraud cases are expensive. They can require hundreds of thousands of dollars in investigative costs alone.
Understanding Medicare's complex rules and regulations is the first step toward building a successful healthcare fraud case.
Working with an experienced Medicare fraud lawyer can make the difference between winning and losing your case.
If you have discovered Medicare fraud, you should immediately speak with an experienced Medicare fraud attorney.
We investigate and prosecute Medicare fraud lawsuits across the United States for whistleblowers under the qui tam provisions of the Federal False Claims Act..
Do I Have a Good Medicare Fraud Case?
The first thing we do is determine if you have a good Medicare fraud case.
Medicare is a federally-sponsored health insurance program for (1) people age 65 and older; (2) people younger than 65 with a disability; (3) people diagnosed with Lou Gehrig's disease; and (4) people with end-stage renal disease.
Cases involving Medicare fraud involve many layers of intricate and detailed information. To thoroughly review your claims, our investigation on your behalf involves three important stages.
First, our Medicare fraud lawyers perform an in-depth background evaluation of your healthcare fraud allegations. To do this, we identify all documents, witnesses, and all other critical evidence that will help your case.
Second, we pinpoint all fraudulent claims and billing practice patterns. We then compare these against CMS instructions and other Medicare benefit regulations to isolate the legal violations in your case.
Third, we thoroughly document our findings and conclusions. We then confidentially disclose these to the Department of Justice on your behalf and assist the government as they conduct their own independent investigation of your whistleblower case.
If you suspect a health care professional is engaging in healthcare fraud, you should always speak with an experienced Medicare fraud attorney before deciding to become a Medicare fraud whistleblower.
Choosing the Right Medicare Fraud Lawyer Can Make All the Difference
Proving Medicare fraud for whistleblowers is highly technical. It involves strict rules of secrecy that most people do not know about.
If you fail to follow these rules, your case will be dismissed.
This is why you should consult with a Medicare fraud lawyer to understand your rights and responsibilities as a federal whistleblower.
Medicare fraud occurs when people or companies bill Medicare for services that were never provided or received. There are many different types of Medicare fraud. They all have the same goal: the unlawful billing of Medicare.
Some of the most common examples of Medicare billing fraud we handle include:
- Double Billing: charging twice for the same service
- Phantom Billing: billing for tests or services not performed and employees who do not exist
- Pharmaceutical fraud: using kickbacks, off-label marketing, price fixing, and other schemes to increase profits from Medicare payments
- Upcoding and Unbundling: inflating bills by using Current Procedural Terminology ("CPT") billing codes or using two or more CPT codes where Medicare requires bundling of such claims together
- Lack of Medical Necessity: billing for services or procedures that are not medically necessary
If you are thinking about reporting Medicare fraud, you will be battling businesses that make a living out of defrauding the government.
Don't fight this battle alone.
Our experienced Medicare fraud attorneys are here to protect your rights each step of the way.
