Laboratories play a critical role in our healthcare system, helping physicians to diagnose diseases and health complications in patients. When laboratories commit fraud, such as billing government-funded healthcare programs for more money than what they are entitled to, it not only hurts the government but it ultimately affects the patients themselves.
Dallas whistleblowers who report healthcare fraud taking place in laboratories or other medical facilities may qualify for a significant financial reward. If you have evidence of lab fraud, contact the Dallas lab fraud whistleblower lawyers of Tycko & Zavareei LLP today for a free, confidential consultation. Learn what may be possible in your case from our expert qui tam attorneys.
What is Lab Fraud?
While most medical professionals in Dallas abide by the laws when it comes to filing healthcare claims, some seek to defraud the government by creating fake or misleading claims in order to obtain unwarranted funds. According to the National Healthcare Anti-Fraud Association, some experts estimate the government loses up to $300 billion a year due to fraudulent medical claims. Under the False Claims Act, creating false claims in order to procure unwarranted funds from the government is illegal and grounds for a qui tam lawsuit.
Examples of Lab Fraud
Unethical healthcare facilities like labs and independent diagnostic testing facilities (IDTFs) commit fraud in order to acquire unjustified funds from Medicare, Medicaid, and the VA in a number of different ways. Lab fraud occurs when medical laboratories engage in illegal activities, including intentionally creating false claims for reimbursement, falsifying test results, and other fraudulent behaviors. Common types of fraud that occur in Dallas labs and IDTFs include:
- Performing and billing for tests that are not medically necessary
- Billing for tests that were performed without a physician’s order or patient’s consent
- Billing for tests that were never performed
- Billing for tests that were provided by unqualified personnel
- Incentivizing physicians or providing kickbacks in order to obtain more business
- Billing for a “bundle” of tests when the physician only ordered one, a process known as bundling
- Billing tests separately that are normally bundled together, or unbundling
- Performing and billing for tests provided at an unlicensed facility
If you believe you have proof of fraud occurring at a lab or an IDTF, contact the Dallas lab fraud whistleblower attorneys of Tycko & Zavareei LLP today to set up a free confidential case review.
Why Should I Report Lab Fraud?
The federal government spends billions of dollars on laboratory services through Medicare, Medicaid, and the VA, with over $7 billion spent on medical testing in 2017 alone. Because federal programs like Medicare and Medicaid are funded by tax revenue, healthcare professionals who commit fraud in order to obtain unwarranted funds affect taxpayers directly.
Additionally, unethical clinical labs that prioritize profits by filing fraudulent claims and evading regulation pose a risk to their patient’s safety. Employees or other individuals who become whistleblowers and report fraudulent activity in labs can help the government shed light on shady business practices, protect taxpayer funds, and promote safety for patients.
How Much Might I Be Rewarded for Reporting Lab Fraud in Dallas?
Qui tam lawsuits filed under the False Claims Act (FCA) are one of the most important tools the government has to combat fraud.
Because of this, whistleblowers who file qui tam lawsuits on behalf of the government may qualify for a significant financial reward if the information they offer leads to the successful recovery of defrauded funds. Whistleblowers who bring successful lab fraud lawsuits are entitled to between 10 and 30 percent of what the government recovers.
In addition to offering financial compensation, the FCA also affords whistleblowers protection from employer retaliation for their bravery in coming forward to report fraud. Whistleblowers who do experience retaliation may qualify to bring a separate lawsuit against their employer for damages, including back pay and attorneys’ fees.
What is the Texas Medicaid Fraud Prevention Act?
The Texas Medicaid Fraud Prevention ACT (TMFPA) was enacted by the Texas state government as a means of addressing fraud against the Texas Medicaid program. Like the federal FCA, this law offers whistleblowers protections and potential financial awards as incentives to come forward regarding Medicaid fraud.
This Texas law has led to the state government recovering millions of dollars in defrauded funds. In 2019, Xerox Corporation reached a settlement with the State of Texas of $235.9 million regarding prior authorization requests for orthodontic services for Medicaid recipients.
If you have proof of lab fraud against the Texas state government or other forms of healthcare fraud, contact the Dallas lawyers of Tycko & Zavareei LLP to set up a confidential case evaluation.
How Can a Dallas Lab Fraud Whistleblower Lawyer Help Me?
Qui tam lawsuits can be complex, and whistleblowers are only rewarded if their case is successful. A qualified lawyer will be able to assist with your lab fraud whistleblower claim by:
- Evaluating all evidence you have and determining the strength of your claim
- Filing your claim under the correct whistleblower programs
- Encouraging the government to become involved with your case, further increasing the chances of a successful lawsuit
- Advocating on your behalf in court
- Protecting you from retaliation from your employer to the fullest extent of state and federal whistleblower laws
- Fighting for the maximum financial reward for your contributions as a whistleblower
Contact a Dallas Lab Fraud Whistleblower Attorney
The attorneys of Tycko & Zavareei LLP are nationally recognized for their efforts in helping whistleblowers expose laboratories and other businesses for committing fraud. Our Texas qui tam attorneys have represented whistleblowers across the country and have assisted in the recovery of millions of dollars in defrauded funds, including $12 million on a toxicology laboratory kickback case.
If you believe you have proof of lab fraud or other forms of healthcare fraud, contact the Dallas lab fraud whistleblower lawyers of Tycko & Zavareei LLP today for a confidential case review.
