Each year, Medicare and Medicaid fraud cost Arizona taxpayers billions of dollars. The FBI estimates that nationally, healthcare fraud costs taxpayers $80 billion every year. While most healthcare providers work ethically and adhere to the laws, there are some that do not.
Healthcare employees that uncover and report fraud at work are called whistleblowers. There are federal and state laws in place that encourage whistleblowers to come forward by protecting them from retaliation and offering a financial incentive if funds are recovered. If you are a healthcare worker aware of fraud within the healthcare industry or have been retaliated against for reporting it, contact the Nevada healthcare fraud whistleblower lawyers at Tycko & Zavareei LLP, one of the top whistleblower law firms in the country, for a confidential legal consultation.
Healthcare fraud is a widespread problem in America, with fraudulent claims accounting for as much as 10% of nationwide healthcare expenses. In just 2020 alone, the Department of Health and Human Services reported over $6 billion in losses to federal healthcare programs. Healthcare fraud occurs in hospitals, private practices, surgical centers, rehabilitation centers, drug treatment centers, and other types of medical facilities.
Healthcare fraud can include:
Established by federal statutes and regulations from the HHS, Medicare is a federal system of healthcare cost reimbursement for certain healthcare expenses for Americans 65 years of age or older. There are several different types of Medicare fraud:
Medicare Advantage (MA) plans are healthcare options that are privately run and offer individuals that are eligible for Medicare additional services that are not normally included with Medicare. The organization collects Medicare payments for each member that vary by risk adjustment, and some MA organizations overexaggerate and overestimate members’ risks and diagnoses in order to get higher payments from Medicare. The ways in which MA organizations may defraud Medicare include:
Designed to provide healthcare for low-income Americans, Medicaid is a federal-state program that directly reimburses healthcare providers for any services rendered to beneficiaries. Medicare fraud can include:
Since the government has limited means of enforcing anti-fraud protection, whistleblowers are given the power to bring whistleblower lawsuits against fraudulent healthcare providers under the False Claims Act (FCA). The FCA gives whistleblowers incentives to come forward with proof of fraud by rewarding them with a percentage of stolen funds that are recovered by the government.
If you have proof of Medicare, Medicaid, TRICARE, Veterans, VA, or similar healthcare fraud taking place, it may be in your best interest to contact a qualified healthcare fraud whistleblower law firm that can explain the legal process and guide you through the steps of filing a whistleblower lawsuit.
At Tycko & Zavareei LLP, our whistleblower lawyers are nationally recognized in the field of whistleblower law and have helped hundreds of whistleblowers shed light on fraudulent healthcare providers. If you have proof of healthcare fraud and are considering taking legal action, contact the Nevada healthcare fraud whistleblower lawyers of Tycko & Zavareei LLP. During a confidential legal consultation, our whistleblower lawyers will thoroughly evaluate your case and help you understand your options.