Who Really Suffers From Medicaid Fraud?

Medicaid fraud affects each and every American citizen. For every dollar defrauded from the government’s pot, it means some form of public service will probably be hit or, taxes will be raised. Medicaid fraud reporting is essential for everyone's sake and in some cases you can actually be offered a cash incentive for your actions.

Medicaid Fraud Reporting - how easy is it and can I help?

If you think you have information relating to Medicaid fraud you really should talk to an experienced lawyer. Usually the first consultation is free and they will be able to tell you whether they think you have a case. They will of course be able to explain what to expect, and as many health care cases are extremely complicated and long winded, be prepared for a long drawn out case. If the lawyer feels there is a case to be answered he can file a suit under the qui tam provision or False Claims Act.

You have now become what is commonly known as a whistle blower and in doing so you may be entitled to a reward, depending on the value of the money recovered. As long as the amount recovered, is in excess of one million dollars you could receive a proportion of this, which is usually between15-30% of the amount recouped.

Medicaid Fraud Reporting - could I lose my job?

Under the qui tam law, you are protected against any reprisals or retaliation, such as threats or harassment plus your employer is not allowed to terminate your employment, demote or suspend you from the workplace.

Medicaid and Medicare fraud is enormous and the government continues year in, year out, to shore up the industry, but for how long can it continue to pump billions into an industry that is one of the largest, and it would appear easiest to defraud.

It would take a book to cover all the various types of fraud happening in the health care industry today. Some of the most common and frequent kinds of defrauding Medicaid are:

• Fraudulent billing for patients that never existed.


• Fraudulent billing, for unauthorised personal care services.


• Fraudulent billing, for services that were never either needed or, provided.


• Bogus time sheets for payment.


• Falsifying Documents.


• Charging for lengthy treatments, when in reality, the treatment had been completed quickly.

It is happening throughout the healthcare industry and it would seem everyone has got on the bandwagon that it’s OK to swindle a few extra few dollars. The problem is, that in many cases scams are huge and they are defrauding the government of millions of dollars.

The people committing this offenses come from all spheres within the health care industry; they can be an individual or individuals and even a health care facility; basically anyone who supplies medical services to Medicaid patients. It's not just doctors and dentists but ambulance providers, day clinics, care or nursing homes, people who supply medical equipment, or any company or organisation that has in some way or other worked for Medicaid.

Medicaid fraud reporting has increased due to the many good citizens taking it upon themselves in reporting this malpractice. Thousands of honest people work within this industry and we can only hope that in the future more people will choose to expose these fraudulent activities.

We need to help the government keep as many community service programmes going as possible, and by doing our bit and reporting fraud within the healthcare sector, we hopefully in our own small way are helping to catch the cheats, the criminals, the tax evaders, the fraudsters. Call them what you want.

Medicaid fraud reporting is not an easy thing to do, as very often we feel we are telling tales on the very people so many of us rely on for our medical needs. But just think, with an ever-dwindling revenue pot, if members of the industry continue to defraud the government of billions of dollars will the Medicaid system be able to continue?