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Florida Medicare/Medicaid Fraud Lawyer

Medicare and Medicaid-related fraud is a type of fraud in which healthcare providers use illegal and deceptive practices to obtain unfairly high payouts from government funded healthcare programs. Medicare and Medicaid fraud can be committed by a wide range of entities and individuals, including medical professionals, patients, suppliers of medical equipment, and healthcare facilities. Fortunately, those who commit fraud against federal programs can be held liable for their actions and individuals who notify the government of the unlawful activities could also be entitled to a reward. To learn more about the claim filing process, please call a Florida Medicare/Medicaid fraud lawyer today.

Common Examples of Medicare/Medicaid Fraud

Fraud committed by healthcare providers often takes the form of billing irregularities, such as:

  • Charging for services that weren’t actually provided;
  • Charging for the performance of unnecessary tests;
  • Charging for unnecessary referrals;
  • Charging separately for services that are usually charged as a package rate, a practice better known as unbundling; and
  • Filing claims for reimbursement to which a claimant isn’t actually entitled.

These, however, are not the only types of fraud in which healthcare providers can engage. Many Medicare/Medicaid fraud claims, for instance, involve allegations of offering, soliciting, or paying for referrals for medical services, a practice also known as taking kickbacks. Other common forms of Medicare/Medicaid fraud include:

  • Illegally pricing drugs;
  • Failing to comply with best pricing in the Medicaid program;
  • Improperly marketing drugs;
  • Overcharging at pharmacies; and
  • Creating or using false records or statements to conceal or decrease an obligation to pay the federal government.

While there are a number of federal task force teams that have been charged with preventing Medicare/Medicaid fraud, this type of fraudulent activity continues to occur at an alarming rate across the country. The federal government does, however, also allow others to report insider knowledge of Medicare/Medicaid fraud and even offers rewards for successful claims.

Filing a Whistleblower Claim

The False Claims Act allows anyone who directly or indirectly causes fraud in government healthcare programs to sue the wrongdoer on behalf of the U.S. These are known as qui tam actions and must be filed under seal in federal district court. This means that the complaint and the evidence it contains will be kept confidential, at least until the seal is lifted. During this time, the government will investigate the allegations and the evidence submitted by the whistleblower. If the government decides to pursue a lawsuit based on this information, the whistleblower could be entitled to between 15 and 30 percent of any award it recovers. Medicare/Medicaid fraud is often widespread and involves thousands of patients and beneficiaries, so this could result in a reward worth millions of dollars for the claimant.

Learn More About Filing a Medicare/Medicaid Fraud Claim

If you suspect that an employer or healthcare provider is committing Medicare/Medicaid fraud and you have questions about filing a whistleblower claim, please reach out to the dedicated Florida Medicare/Medicaid fraud lawyers at McCabe Rabin, P.A. by calling 561-659-7878 for an assessment of your case.

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