Medicare is a lifesaving federal program for millions of seniors, people with disabilities, people with low income and more. Sadly, various groups and individuals commit fraud against the program—resulting in billions of dollars of stolen healthcare funds.
Medicare fraud can severely affect the country’s ability to help those who need it. Learning to recognize the signs of possible Medicare fraud and letting the authorities know about it is crucial to helping the program offer much-needed health coverage.
Common examples of Medicare fraud
Some signs of Medicare fraud to watch out for include:
- Bills for services the patient did not receive
- Bills for unnecessary services that patients received
- Invoices or orders of equipment patients did not receive
- Multiple bills sent for the same service or equipment
- Free offers for testing or screening to get a person’s Medicare number
- Upcoding or using wrong billing codes to get higher reimbursements
- Payments or gifts for referring patients to specific doctors or hospitals
Who commits Medicare fraud?
All kinds of healthcare providers can potentially commit Medicare fraud. Aside from hospitals and doctors, the following may also commit healthcare fraud:
- Pharmacists
- Chiropractors
- Suppliers of durable medical equipment, such as wheelchairs
- Nursing homes
- Medical transport providers, such as ambulance companies
- Medical laboratories and diagnostic testing facilities
Filing a qui tam case for Medicare fraud
If you suspect a Medicare fraud scheme, the federal government highly encourages you to come forward and report your suspicions. Whistleblowers are crucial to maintaining the spirit and integrity of our healthcare programs. Before coming forward with your information, it is best to seek legal guidance to ensure you gather sufficient evidence and follow the proper procedures.
Filing a qui tam lawsuit is not an easy task. Having an experienced legal team by your side can help you understand the risks, requirements and communicate more effectively with the authorities.
