Healthcare fraud is a common tactic used to misappropriate and draw down government funds. If you have information about healthcare fraud, you could help save taxpayers millions of dollars, protect vulnerable patients, and penalize corrupt providers who attempt to take advantage of the system. Jacksonville healthcare fraud whistleblowers may also qualify for financial rewards and protection against retaliation by their employers.
Becoming a healthcare fraud whistleblower is protected by federal and state law. For more information about blowing the whistle on attempts to steal taxpayer funds or make false claims to the government, contact a Jacksonville healthcare fraud lawyer today. The team at Tycko & Zavareei LLP is ready to help you report what you know while protecting your rights and interests as a whistleblower. Our experienced qui tam attorneys have helped settle dozens of healthcare fraud cases involving high payouts for whistleblowers across America. Do not wait to come forward if you suspect healthcare fraud – speak up today.
Whistleblower Rewards for Reporting Jacksonville Healthcare Fraud
According to the federal False Claims Act, anyone who attempts to make false claims to the government, including submitting false claims for funding or payments, can be held liable for up to treble damages. Individual financial penalties can also be assessed for each false claim. The amount of these penalties is linked to national inflation rates. Florida statutes also back up federal law in instances of state-related Medicaid fraud.
Under the False Claims Act, also known as the Lincoln Law, those who come forward with information that helps the government recoup stolen funds can be eligible to receive anywhere from 15 to 30 percent of the recovered funds. The percentage a qui tam relator, or whistleblower, can receive varies based on their involvement and the kind of information they can provide. Cooperating with a Department of Justice investigation can increase your financial reward as a whistleblower, and waiting to come forward or obstructing the process can reduce a whistleblower payout.
This federal law also provides substantial protections for whistleblowers against employer retaliation. Specifically, it is prohibited to fire, demote, harass, or otherwise take retaliatory action against a whistleblower. Reduction of pay or hours is also illegal after a protected disclosure. Attempts to do so may result in additional liability for an employer accused of fraud. They may be subject to financial penalties such as double back pay and legal fees, as well as the possible reinstatement of a wrongfully terminated whistleblower.
Who Can Become a Jacksonville Healthcare Fraud Whistleblower?
Most commonly, healthcare fraud whistleblowers are employees of medical providers or insurance companies. Healthcare fraud whistleblowers may work in billing and spot discrepancies in certain claims made for government funds. They may also be doctors, nurses, or technicians themselves who have knowledge of a patient’s condition and needs.
Oftentimes, attempts to illegally draw down Medicare/Medicaid funds involve misreporting tests ordered or exaggerating the level of care provided. Caregivers as well as case workers in hospitals and doctors’ offices can be well-positioned to report on fraud that might otherwise go unchecked.
Finally, whistleblowers may also be patients themselves, or those who have loved ones receiving care that is billed to Medicare, Medicaid, the VA, or any other government services. If you have suspicions about the level of care being provided not matching the bills you see, or worries about unnecessary tests being ordered or prescriptions being given, you may be able to report healthcare fraud in Jacksonville.
Common Examples of Jacksonville Healthcare Fraud
The Centers for Medicaid/Medicare Services (CMS) lists several common types of healthcare fraud. If you spot any of the following in your line of work, you may be eligible to become a whistleblower.
- Billing for unnecessary treatments or services not given to patients
- “Unbundling” by billing for services separately that could be covered under one global code
- “Upcoding” by billing for more complex or costly services than what was actually rendered
- Prescribing unnecessary drugs, altering prescriptions for non-medical reasons, or selling prescription drugs for financial gain
- Giving or receiving kickbacks
- Knowingly billing for ineligible beneficiaries or claiming reimbursement for services provided to ineligible beneficiaries or services
Why Report Healthcare Fraud?
Millions, if not billions, of dollars are leeched out of the national healthcare system in Jacksonville alone. Recent cases involving Jacksonville healthcare fraud settlements have numbered into the millions of dollars. One 2016 settlement involved $10 million in payments from pharmaceutical companies over compounding prescription violations. Not only was fraudulent billing involved for patients, but the scam also involved pharmaceutical companies and hired promotional firms who marketed to military families via Facebook and other social media networks. These advertisements preyed on servicemembers who searched for pain relief or scar reducers, enrolling them in so-called “research trials” that cost the government millions.
Florida is unfortunately rife with pharmaceutical fraud. A 2020 Jacksonville healthcare fraud case involved a $1.4 million payout in order to address allegations that a Jacksonville radiology firm submitted false claims for reimbursement. Medicare and Medicaid only reimburse interpretations of radiological images if they are read within the United States. This Jacksonville firm was investigated for allegedly billing for initial interpretations performed outside of the US, or double billing for re-interpretations performed by domestic radiologists.
Reporting healthcare fraud can not only help save taxpayer money, but it can also save lives. In cases of Medicare and Medicaid fraud, rates of emergency hospitalization tend to rise for those who are treated by corrupt doctors and other medical practitioners. The risk of emergency hospitalization is estimated to be 11 to 30 percent higher, compared to rates of risk for patients who are seen by doctors who have never been accused of healthcare fraud. Similarly, mortality rates for patients who received care from doctors later accused of healthcare fraud have been found to be 13 to 23 percent higher than they are for control groups.
Speak to a Jacksonville Healthcare Fraud Attorney Today
If you have information that could expose ongoing healthcare fraud in Jacksonville, consider blowing the whistle by speaking to our law offices today. Our experienced qui tam attorneys can help you report fraud and abuses in the healthcare industry while protecting your rights and privileges as a whistleblower. You may be able to protect millions of taxpayer dollars while also ensuring that Florida patients receive the level of care they deserve.
Don’t wait to come forward as a Jacksonville healthcare fraud whistleblower. Once information has already been reported, it becomes ineligible for a financial reward. Waiting to speak up may also create liability or increased scrutiny for your own role in a healthcare fraud scheme. Speak to a Jacksonville healthcare fraud lawyer today to protect your own interests while doing the right thing. A consultation with Tycko & Zavareei LLP about the facts of your case is free and confidential.
