Medicare Fraud

Medicare fraud is estimated to cost over $60 billion a year and has become one of the most profitable crimes in America.

Types of Medicare Fraud

A Medicare scam Medicare abuse may include:

  • Phantom billing—billing for tests not performed
  • Performing inappropriate or unnecessary procedures
  • Charging for equipment or supplies never ordered
  • Billing Medicare/Medicaid for new equipment but providing the patient with used equipment
  • Offering free services or supplies in exchange for your Medicare number
  • Code Jamming—Laboratories inserting or “jamming” fake diagnosis codes to get Medicare coverage
  • Double billing—Charging more than once for the same service
  • Improper cost reports—Submitting false cost reports seeking higher Medicare reimbursements than permitted by actual facts
  • Phantom employees—Expensing employees or hours worked that don’t exist
  • Be suspicious of any medical provider that doesn’t charge a copayment or regularly waives this fee.

Determing Medicare Fraud

Fraud under the False Claims Act means that a contractor has knowingly presented a false claim for payment to the United States government. The fraud can occur wherever federal or state monies are directly or indirectly used to purchase goods or services. The Qui Tam provision is a mechanism in the law that allows those with evidence of fraud against federal programs or contracts to sue the wrongdoer on behalf of the government. Overall, qui tam actions have returned over $7.8 billion to the government since Congress amended the False Claims Act in 1986.

Medicare Fraud Legal Help

If you have been contemplating blowing the whistle on fraud against the federal government, you should seek advice from a qualified attorney. They can provide you with information and resources to assist you with your case. If you’ve been charged with Medicare fraud, you will need to be represented by a lawyer.