Pueblo CO Medicare Attorney
Medicare and Medicaid fraud is rampant. It drains our system of precious resources, makes the overall cost of health care more expensive, and it deprives those who need it of necessary coverage. In many cases, doctors who commit Medicare and Medicaid fraud are also committing medical malpractice.
In this article, we’ll talk about different kinds of Medicare and Medicaid fraud and how the government will compensate you for blowing the whistle on those medical providers who are abusing both you and the system. If you suspect Medicare fraud, contact a Pueblo CO Medicare attorney at Brylak Law today.
Who Are Victims of Medicare and Medicaid Fraud?
Every American who pays money into the system is being victimized by predatory billing practices. These practices come in many forms and different individuals are each in a different position to take note of what is happening. Doctors, nurses, hospital personnel, and patients have all stepped forward to report these fraudulent practices and the government rewards them handsomely for doing so.
Whistleblowers May Be Able to Obtain Compensation
We can go over billing statements to help establish a qui tam case against the health care provider. Qui tam cases are specific kinds of whistleblower actions in which the government recovers funds from an institution that is committing fraud against it. Whistleblowers are entitled to a percentage of whatever funds the government recovers. Our Pueblo CO Medicare attorneys will help maximize your recovery while minimizing the risk to you. At Brylak Law, we have handled a number of such cases securing excellent rewards for our clients.
Types of Fraudulent Medicare Practices
There are several different kinds of Medicare or Medicaid fraud. These include:
- Phantom billing. The health care provider bills Medicare that the patient never received.
- False cost report. Medicare may make payments to a health care provider throughout the year, but there is an overage at years end. The health care provider files a false report in order to return money to Medicare.
- Medicare theft. A patient may use another patient’s Medicare in order to receive medical care.
- Unnecessary testing. A doctor may send a patient for several unnecessary tests in order to charge the patient’s Medicare. The patient generally doesn’t know any better and Medicare is generally permissive about green-lighting tests. This is not only a violation of Medicare fraud laws, it also qualifies as medical malpractice.
- Inflating statistics. Sometimes hospitals will report false statistics on their quality of care in order to justify higher bills to Medicare. This is also fraud.
How a Pueblo CO Medicare Attorney Can Help You
Under the False Claims Act, an individual can bring a lawsuit against another individual or entity that they are aware has committed fraud against the government. This individual files the lawsuit on the government’s behalf and shares a portion of the settlement with the government. These are known as “qui tam” lawsuits.
Our Pueblo CO Medicare attorneys have successfully managed a number of Medicare fraud lawsuits in order to hold those accountable who abuse the system and waste our tax money. These lawsuits are then filed “under seal” which allows you to protect yourself from retaliation. The government will conduct an investigation of its own, but will rarely use their own lawyers to pursue a qui tam case. Their participation in the process, however, will help you and your attorney build the case against the accused party.
In the majority of situations, the seal will be lifted after the investigation is complete. At that point, the government will discuss the allegations with the party that committed fraud and begin settlement negotiations. Generally speaking, this is preferred to a jury trial.
What You Can Expect in a Qui Tam Lawsuit
Depending on how involved the government is in the investigation process and litigation, the whistleblower in a qui tam lawsuit may receive anywhere from 15% to 30% of all the funds recovered. This can amount to a very large sum of money. Not only is a guilty party liable for the money that they defrauded the government out of, they are charged a punitive fine of three times that amount for their fraud.
If you are an employee of the company that you blew the whistle on, federal law protects you from retaliation. While it is likely that your employer will not be happy with you, if they attempt to fire, demote, suspend, or otherwise threaten your job, the federal government will ensure that you are reinstated.
In addition, you personally may be able to collect damages for wrongful discharge. This includes twice the amount of your back pay with interest tacked on.
Contact a Pueblo CO Medicare Attorney Today
The potential payoff for blowing the whistle on Medicare fraud is significant. It also does yourself and your fellow taxpayers a great service. If you have first-hand knowledge of Medicare fraud, contact Brylak Law today to set up an appointment.