The largest penalties issued under the False Claims Act have involved health care fraud. Health care fraud can be perpetrated by health care providers, patients, insurers or health managed care organizations or the suppliers of medical equipment, supplies or medications.
If the fraud results in reimbursement or payments through Medicaid, Medicare, Social Security or a state insurance program, it may fall under the False Claims Act, also known as the Qui Tam Statute, which rewards whistleblowers for calling attention to fraud against the government.
The U.S. Department of Justice reported health care fraud civil recoveries of
$2.5 billion in Fiscal Year 2010, or 83 percent of the year’s total civil fraud
recoveries.
If you are aware of any health care provider that may be cheating government
programs, call the False Claims Act lawyers at Gordon & Doner at (800) 659-1159
or contact us online for a free case
evaluation. We can advise you on the strength of your case.
If your claim has merit, we'll help you file a lawsuit to stop the fraud --
and we will help you recover anywhere from 15 percent to 30 percent of the money
in a successful lawsuit.
The attorneys at Gordon & Doner have received professional accolades for their
work representing clients in
West
Palm Beach,
Martin
County,
Stuart,
Pembroke
Pines,
Miami and
throughout Florida.
Common Types of Health Care Fraud
Common types of health care fraud occur through overbilling or misrepresenting
the goods or services that are provided. The fraud can include:
- Performing unnecessary procedures or tests;
- Billing multiple times for the same item;
- Listing a test that is more expensive than the test that was actually run;
- Billing for brand-name medications when a cheaper generic drug was actually supplied;
- Billing at a doctor level rate for work that was performed by a nurse or other assistant.
Health care fraud often occurs in long-term care settings, including nursing homes or elder care facilities. Residents of long-term care facilities, or the children of those residents, may not always be able to keep a watchful eye on expenses in those facilities.
Suppliers, government contracts
Overbilling or misrepresenting services is not limited to health care providers. It can also occur when manufacturers or medical suppliers inflate prices for equipment or supplies to a government agency, such as the military. Repeated overbilling, even on small-ticket items, can result in a substantial loss to the government and a large claim.
