How to submit a tip-off in relation with Medicare program violations?

Fraud against healthcare or Medicare and Medicaid has been a long problem in the society – typically committed by medical equipment suppliers, medical practitioners, and related divisions that often claim money from Medicare programs they never actually provided – is a growing, multibillion-dollar state and federal issue. Our attorneys at Brown, LLC have investigated and prosecuted hundreds of related cases, some of which have been brought to justice by Medicare beneficiaries who noticed something hadn’t looked right, hence reported it. Medicare and Medicaid fraud has long been on the rise and hurting the country’s economy, thus healthcare. This article will explain the Medicare and Medicaid fraud reporting process and how to be eligible to receive a monetary whistleblower reward.

Example of reporting Medicare misconduct

Let’s suppose a healthcare center plans to defraud Medicare and Medicaid. The easiest way of carrying it out is upcoding, meaning billing higher than allowed, for instance, billing for malaria treatment while the patient had a cold. Another easy way of defrauding Medicare or Medicaid is billing for services that were never necessary or even provided, such as to bill for medical tests never performed or to order unnecessary tests. Hospitals often try to defraud insurance companies in similar ways, however, the reward program only pays the reward for tipping-off misconduct against Medicare and Medicaid or related government programs. If a hospital, therefore, is upcoding for most of their patients, the reward program will only assess through the fraud against Medicare or Medicaid, or other related government programs. For Medicare and Medicaid are a major part of hospital practice, the level of misconduct gets high fast. The key to acquiring a reward for tipping-off Medicare fraud is to possess evidence and then report extensive fraud against Medicare and Medicaid is based on how much fund the government might collect in the prosecution. It’s not typically worth the government’s time to investigate a Medicare fraud case if there’s no proper evidence in place already.

How can you report Medicare fraud and receive a reward?

To report unfitting billing or claiming, or be suspicious of a fraud

Attorneys at Brown, LLC protect the integrity of healthcare programs by ensuring that proper and fitting payments have been made for the right services. Our attorneys are dedicated and specialized in protecting taxpayers’ dollars by ascertaining the right doctor, pharmacy, patient or the right person obtains the right amount of payment at the right time.

What Brown, LLC’s Medicare fraud whistleblower attorneys deal with

Whistleblowers can submit their tip-off where they suspect that healthcare service provider has long been committing fraud or incorrectly billing as to health programs.

Healthcare service providers Brown, LLC’s attorneys address include:

Doctors, dentists, pharmacists, and allied health professionals

Organizations include pharmacies, medical practices, hospitals, and administrative staff.

Your reporting has to be about:

Fraud – For instance, where a medical practitioner bills their patients for service the patient never received, or where a pharmacist claims for a drug or equipment that was never supplied out.

Unfitting billing or claiming – For instance, where medical practitioner bills for a completely different service than was offered or for further services that were never offered.

Submitting a claim to the Department of Health

What must you do if you see a name you don't acknowledge on your Medicare statement?

We usually acknowledge the names of our doctors, but never really care to learn the names of the specialists who look at our x-rays, check our eyes, or analyze our blood tests. Consider if you have had additional health tests or appointments.

If you have a suspicion about a doctor, call the dedicated hotline.

Provider Benefits Integrity Hotline

If you have suspicions regarding a doctor, you can always consult with one of our Medicare fraud whistleblower lawyers at Brown, LLC, and complete the tip-off form under their thorough guidance.