Medicare / Medicaid Fraud

Medicare and Medicaid are federal programs that assist millions of Americans in getting the medical care they need. Providers who accept Medicare and Medicaid payments have very strict guidelines for what’s allowable.  Unfortunately, not all providers handle things in...

If you work in the health care industry at a doctor’s office, a clinic or even a hospital – you may have come across some billing practices that seem a little sketchy to you – even if you aren’t exactly sure what you are seeing. One of the most common ways that...

We recently discussed major types of Medicare fraud, which include unnecessary tests, billing for services that weren’t provided or overbilling for services to inflate the costs. These are all things that a whistleblower may want to be aware of because they can report...

Medicare fraud can take many different forms. Whistleblowers need to know what to watch out for and what steps they can take when they see it happening. At its heart, most Medicare fraud is financial in nature. The goal is simply for the provider or another entity to...

Medicaid serves as a lifeline for millions of seniors. This vital program can cover the total cost of nursing home care for eligible individuals. However, the system faces threats from fraudulent practices. Recognizing signs of Medicaid fraud in nursing homes helps...

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...

Millions of Americans, particularly the elderly and disabled, rely on the critical support Medicare provides. However, this essential service is under constant threat from fraudulent activities. Medicare fraud drains valuable resources away from those who need them...

One reason why whistleblowers decide to speak out is when they see evidence of Medicare or Medicaid fraud. These are government benefits systems that can cover the cost of certain medical treatments. Because Medicaid can be billed for those treatments, there are those...

The intersection of private insurers and government-sponsored programs often gives rise to unique challenges. One such challenge is insurance providers taking advantage of the federal government’s Medicare Advantage program through adjustment fraud. Medicare...

As a Medicaid recipient, you have the right to receive necessary medical care and services that help improve your health and well-being. However, sometimes, health care providers may bill for services that are not medically necessary or may upcode (bill for more...