Each year, Medicare fraud committed by healthcare providers costs American taxpayers billions of dollars. Fraudulent medical providers submit falsified records or claims that are intended to mislead the government in order to obtain unwarranted funds.
In order to address rampant fraud, the government relies on the False Claims Act and whistleblower cases to recover defrauded funds. Whistleblowers who come forward with valuable information can receive financial incentives as well as protection from retaliation for their help.
If you have proof of healthcare fraud, contact the Fort Worth Medicare fraud attorneys of Tycko & Zavareei LLP today for a free, confidential case evaluation.
What Are Examples of Medicare Fraud?
Any company or healthcare provider’s actions that seek to defraud U.S. public health insurance programs, such as Medicare or Medicaid, out of funds or otherwise procure unwarranted funds is considered fraud. Some of the most common ways in which companies or healthcare providers seek to defraud Medicare include:
- Billing for care or services that were never provided: One of the most common forms of Medicare fraud, this includes billing for services that were not performed or even prescribed.
- Upcoding and unbundling: This refers to when a healthcare provider bills for more expensive diagnoses or procedures than were provided or when providers bill multiple services separately in order to be reimbursed for a higher amount.
- Medical necessity fraud: This refers to providers prescribing drugs, treatment, or services that are medically unnecessary for the patient in order to obtain more Medicare or Medicaid reimbursement. This practice can also be especially dangerous for the patient.
- Providing or accepting kickbacks: When a doctor receives an incentive from a pharmaceutical company for prescribing patients the company’s brand of drugs, it is considered a kickback. This also includes medical device manufacturers who offer healthcare providers gifts for the use of their products.
- Pharmaceutical fraud: Encouraging the off-label use of pharmaceuticals is a form of pharmaceutical fraud.
Who Can Become a Fort Worth Medicare Fraud Whistleblower?
Anyone who has non-public information or proof regarding a healthcare provider defrauding Medicare may be able to bring forth a whistleblower lawsuit under the False Claims Act.
While anyone can become a Medicare fraud whistleblower, it is most commonly people with inside information who have the tools to accurately report healthcare fraud. This may include:
- Medical billing coders and specialists
- Accountants
- Nurses
- Physicians
- Healthcare administrators
Are Fort Worth Medicare Fraud Whistleblowers Protected?
Many potential whistleblowers who have knowledge of Medicare or Medicaid fraud are apprehensive to come forward due to fear of retaliation from their employer for their role in filing a whistleblower claim. In order to encourage and protect whistleblowers who come forward to help address fraud, whistleblowers in America are protected under the False Claims Act.
Under the False Claims Act, qui tam relators (also known as whistleblowers) are protected from employer retaliation. Examples of retaliation that are illegal might include:
- Suspension
- Demotion
- Termination
- Reduction of pay or hours
- Other discriminatory acts meant to serve as retaliation for coming forward as a whistleblower.
If whistleblowers are retaliated against by their employer, they have the right to file a lawsuit for reinstatement if terminated or demoted. They may also be entitled to back pay plus additional added interest, and the reasonable cost of an attorney’s assistance in filing the suit. If you experienced retaliation after becoming a whistleblower, contact the Fort Worth Medicare whistleblower lawyers of Tycko & Zavareei LLP today to understand your legal remedies.
Are Whistleblowers Rewarded for Exposing Fort Worth Medicare Fraud?
Under the qui tam provision of the False Claims Act, whistleblowers whose tips regarding Medicare fraud lead to the recovery of defrauded funds from the defendant are eligible for a financial reward for their bravery. This financial incentive falls between 15 and 30 percent of the total recovered funds, depending on whether or not the government agrees to intervene as part of your qui tam case.
In whistleblower lawsuits with added government intervention, the settlement amounts are often in the millions or billions, leading to significant financial rewards for whistleblowers on the case.
Experienced Medicare fraud attorneys in Fort Worth know the best way to get the government to intervene with a qui tam lawsuit is to provide the strongest case possible. At Tycko & Zavareei LLP, our lawyers have represented whistleblowers across the country and assisted in the recovery of billions of dollars.
Choosing the Right Fort Worth Whistleblower Law Firm
Due to the complexity of whistleblower law and the Medicare fraud claims process, it is in your best interest to consult with an experienced qui tam lawyer if you are considering filing a whistleblower claim. Building a strong case with the proper evidence is vital to a strong qui tam lawsuit. A qualified qui tam law firm will be able to advise and guide you through the Medicare whistleblower legal process in Fort Worth, TX.
At Tycko & Zavareei LLP, our Medicare fraud lawyers have decades of experience representing whistleblowers across the U.S. whose bravery has exposed billions of dollars of corporate fraud taking place. Our qui tam law firm has assisted in the recovery of billions of dollars.
Contact a Fort Worth Medicare Fraud Attorney
Whistleblowers who have proof or non-public knowledge of a healthcare provider defrauding Medicare may be eligible to receive a financial reward for their contributions as a qui tam relator. Additionally, you will be protected from employer retaliation for your whistleblower actions under the False Claims Act.
If you are considering a Medicare fraud whistleblower claim or have experienced employer retaliation for your Medicare fraud whistleblower tips, contact the Fort Worth Medicare fraud lawyers of Tycko & Zavareei LLP today for a confidential Medicare fraud whistleblower case evaluation at no cost to you.
