To receive reimbursement from government-funded healthcare programs like Medicaid for their services, healthcare providers must file claims with the appropriate billing information for the medical care provided. When healthcare providers intentionally file claims that are misleading or false in order to obtain unwarranted federal funds, they could be in violation of the False Claims Act.
Healthcare fraud and other violations of the False Claims Act cost the government and taxpayers billions of dollars every year. Whistleblowers with valuable information about Medicaid fraud can help shed light on fraudulent business practices and potentially receive a financial reward for their contributions. Contact Tycko & Zavareei LLP’s Medicaid fraud attorneys in Fort Worth today for a free legal consultation.
What is Medicaid Fraud?
According to data from the Centers for Medicare & Medicaid Services, Medicaid fraud cost the US government over $80 billion in 2020 alone. Medicaid or Medicare fraud occurs when healthcare professionals falsify claims in order to procure unjustified money from the government. Common examples of Medicaid fraud in Fort Worth include:
- Billing for services that were not provided
- Performing and billing for services that were not medically necessary
- Billing procedures separately that are normally grouped together, otherwise known as unbundling
- Billing for services of higher complexity than what was actually performed
- Submitting false records
- Offering illegal bribes like kickbacks
- Marketing pharmaceuticals or medical devices for off-label usage
How Does the False Claims Act Help Fight Medicaid Fraud in Fort Worth?
The False Claims Act (FCA) was enacted by President Lincoln during the civil war to combat fraud against the government. Today, it is still the primary tool the government uses to find and stop individuals or businesses that defraud the government and its programs.
The FCA contains a provision called qui tam that allows a private citizen to bring a lawsuit on behalf of the government against a company committing fraud. Whistleblowers, otherwise referred to as qui tam relators, are afforded protections for becoming a whistleblower as well as compensation if their qui tam lawsuit leads to the successful recovery of defrauded funds.
Texas Medicaid Fraud Prevention Act
In 1995, Texas passed a law similar to the FCA called the Texas Medicaid Fraud Prevention Act (TMFPA) that allows private citizens with proof of a healthcare worker or healthcare organization’s efforts to defraud the Texas Medicaid program in order to receive excess benefits to file qui tam lawsuits. Like the federal FCA, whistleblowers whose tips regarding Texas Medicaid fraud lead to the state government successfully recovering defrauded funds are entitled to receive a portion of the total amount recovered.
If you have proof of fraud against the Texas Medicaid program, contact the Forth Worth Medicaid fraud attorneys of Tycko & Zavareei to speak with a qualified whistleblower lawyer.
How Are Fort Worth Whistleblowers Protected?
Whistleblowers who bring qui tam lawsuits regarding fraud against the state or federal government, including Medicaid fraud, are given certain protections under the FCA. For example, the FCA makes it illegal for an employer to retaliate against a whistleblower. Retaliation can look like the whistleblower being suspended, demoted, or terminated without a clear cause. It can also include harassment and discrimination.
Under the FCA, whistleblowers who do experience retaliation can take legal action against their employers. Specifically, workers who were retaliated against after blowing the whistle on Medicaid fraud may qualify to bring a lawsuit against their employer for damages such as reinstatement, back pay, and attorneys’ fees. If you have been retaliated against by your employer for becoming a whistleblower, contact the Forth Worth Medicaid fraud lawyers of Tycko & Zavareei LLP today for a free legal case review.
Importance of Reporting Medicaid Fraud
Because American tax dollars help fund federal government programs like Medicaid, when individuals or companies seek to defraud those programs, they are defrauding American taxpayers too. Whistleblowers who bravely come forward with valuable information regarding fraud against the government could receive significant compensation.
If a whistleblower’s qui tam claim leads to the government successfully recovering defrauded funds or reaching a settlement, the qui tam relator could be eligible to receive between 15 and 30 percent of the total funds that are recovered.
Contact a Fort Worth Medicaid Fraud Lawyer Today
If you have proof of a business or individual committing fraud against the government, including Medicaid fraud, reporting the information could lead to a significant financial reward if your whistleblower lawsuit is successful. Filing a whistleblower lawsuit may feel overwhelming, but an experienced Medicaid fraud attorney serving Fort Worth, TX can guide you through the legal process and answer any questions you may have.
However, it is important that you consult with a qualified lawyer to ensure your rights are protected and that your lawsuit has the best chance of resulting in financial recovery.
The Fort Worth Medicaid fraud attorneys of Tycko & Zavareei LLP have represented whistleblowers across the country in qui tam cases that have settled for millions of dollars, including a medical device kickback case that settled for $350 million and various other multimillion-dollar settlements.
Contact Tycko & Zavareei LLP to speak with a qualified lawyer today.
