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Medicare and Medicaid Fraud

Whistleblower Fraud Attorneys

Medicare and Medicaid programs make healthcare available to people of retirement age, the disabled, children of low-income families, and low-income adults. Funded by tax dollars, the programs are constantly under threat of budget cuts, but an estimated $60 billion a year is stolen from Medicare alone, through Medicare fraud. If you have knowledge of Medicare/Medicaid fraud, please talk to the whistleblower fraud attorneys of Hastings, Cohan, and Walsh, LLP, today.

Examples and Signs of Medicare/Medicaid Fraud

Medicare and Medicare fraud include billing for services which are not received, providing services that are not needed, overcharging for services, and more, with the end goal of collecting extra money from Medicare or Medicaid reimbursements. Examples and warning signs of Medicare and Medicaid fraud include:

  • Double billing – billing twice for a service rendered once
  • Upcoding – using a more expensive billing code for a diagnosis or service
  • Bundling or unbundling inappropriately – billing for a group of tests when only one was performed, or charging separately for a group of tests that cost more individually than as a bundle
  • Billing for services that were not provided
  • Performing unnecessary procedures
  • Partially filling prescriptions while billing for the full prescription
  • Billing for a more expensive version of a drug
  • Kickbacks paid to encourage prescribing certain drugs or using certain equipment
  • Off-label marketing of drugs or equipment
  • Fraudulent cost reports
  • Billing Medicare or Medicaid patients more than other patients for the same services or products
  • Diagnosing a patient with a more serious condition than they actually have resulting in more expensive testing and treatment
  • Falsely certifying that procedures are necessary which they are not
  • Billing for medical equipment which is not received
  • Continuing to bill for in-home medical equipment after it has been returned
  • Billing for patients who do not exist
  • Research grant fraud

Perpetrators of Medicare/Medicaid Fraud

Medicare and Medicaid fraud can be very profitable for those who commit it. That profit comes, not only at the expense of American taxpayers in general, but can also be detrimental to the health of individual Medicare and Medicaid patients. Examples of those who may have committed Medicare/Medicaid fraud include:

  • Insurance companies
  • Doctors and other healthcare practitioners
  • Hospitals, clinic, and outpatient facilities
  • Nursing homes and assisted living facilities
  • Mental hospitals
  • Other healthcare facilities
  • Home healthcare companies
  • Pharmacies and pharmacists
  • Medical equipment suppliers

If you are considering a whistleblower lawsuit involving MediCare or Medicaid fraud, please contact the whistleblower attorneys of Hastings, Cohan, and Walsh, LLP, right away. We work with whistleblowers nationwide. We can help you receive the maximum award for your efforts and exercise your rights under whistleblower protection laws.

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Pharmaceutical Fraud

Pharmaceutical fraud costs more than taxpayer dollars, it often costs lives. In July, 2012, GlaxoSmithKline (GSK) agreed to pay a record-breaking $3 … [Read More...]

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