Healthcare Fraud – The Government Needs Your help
Over 45 million disabled and elderly citizens are currently enrolled in Medicare plans which are funded by the tax payer, and alarmingly healthcare fraud in the US is huge with unscrupulous and greedy companies fleecing the government on a regular basis. It's a sad fact of life when the very people who are treating the company's elderly and disabled citizens seek to profit from the medical needs of these people.
In February of last year, 2011, the US government charged 111 doctors, nurses and other individuals with false billing crimes amounting to over $225 million. This is shocking and it is clear that something has to done about it.
How do they get away with it?
The types of people who commit these frauds vary from individual doctors and pharmacists as well as high-level hospital administrators. They are clever in their actions and will often set up complicated billing systems to cover their tracks and avoid suspicion. Some of the more common ways that they intentionally defraud the government are by:
- billing twice for the same services or goods
- charging for expensive equipment and supplying the patient with cheaper goods
- doctors may bill in hours for non existent staff
- pharmacists claim for prescriptions for patients long deceased
- accepting kickbacks
And so the list goes on.
How does it concern me?
Every time that a false claim is billed to the government, in effect that is more money coming out of the “pot” which is available for healthcare. The government are left with one of two options which are to cut back on other government services or to raise taxes in order to claw back some of the shortfall. Now as a taxpayer, you must surely be angry that you have to pay more taxes so that unscrupulous companies and individuals can continue to cheat the Government by means of healthcare fraud.
How can I help?
President Obama's government has resurrected an ancient law known as 'qui tam' which means that any individual who reports a healthcare fraud to the Government can be entitled to a share of the monies recovered provided the amount is over $1 million. By offering financial incentives, the government is hoping that whistleblowers will come forward and that they can begin to crack down heavily on the fraud that continues to dominate Medicare. If you have reason to believe that a fraud is being committed, maybe in the doctor's practice where you are a receptionist, then you should in the first instance contact a reputable qui tam lawyer who will be able to advise you and, if there is a case to be answered, will be able to help you every step of the way.
How you can help as a patient?
If you are a Medicare patient, then you can do your bit too, by following some of the guidelines below:
- make sure you fill out claim forms one at a time, carefully checking them, before signing and dating each one
- if your doctor or health care institutions suggests various procedures or products, ask why they are necessary and how much they cost
- never give out your health care information to anyone over the phone unless you have a prior agreement with them
- be wary of special promotions or 'free' services. Nothing is free and you could well get charged through the nose much later
If you are suspicious of any actions by your doctor, nurse or healthcare institution, or of anyone cold calling and asking you to disclose your healthcare information, then do the right thing and report it.
A whistleblower who is successful in a large lawsuit may reap a reward of between 10-30% that could be a life-changing sum of money. You owe it to yourself and to other American taxpayers to do the right thing and help the government crack down on healthcare fraud.
