Financial statement indicating medicare fraud.

What is Medicare Fraud?

Medicare fraud is a practice that involves the claiming of Medicare health care reimbursement to which a claimant is not legally entitled. Medicare fraud is routinely committed by individuals, pharmaceutical companies, medical teams, and healthcare facilities. Medicare fraud negatively affects taxpayers and the government, which is why the government encourages those with knowledge of Medicare fraud to report it upon discovery. In order to encourage the reporting of Medicare fraud, the government offers whistleblowers significant financial compensation for information that leads to the recovery of Medicare funds. If you have information that an entity or person has committed Medicare fraud, you should contact a Medicare fraud whistleblower attorney immediately for assistance. Below is an overview of Medicare fraud in the U.S. 

Types of Medicare Fraud

There are several types of Medicare fraud, including:

Kickbacks – A kickback occurs when one solicits, offers, or pays for referrals for medical services or items. 

Upcoding – Upcoding involves billing for services at a higher price than what was actually provided. 

Billing for unnecessary services or items – It is illegal to intentionally bill for unnecessary services or items in order to generate extra revenue. 

Billing for items or services that weren’t provided – It is illegal to bill Medicare for items or services that were never provided. 

Unbundling – Unbundling is a practice that involves entering several codes for procedures that only require a single code, thereby increasing the amount of payments provided by Medicare. 

Drug diversion – Drug diversion is an illegal practice that involves writing unnecessary prescriptions to obtain medications to sell or keep for personal use.

Card sharing – When a provider purposely treats and claims reimbursement for a person other than an eligible beneficiary, this is known as card sharing.

Collusion – Collusion occurs when one knowingly collaborates with a beneficiary to file false reimbursement claims. 

Financial Compensation for Reporting Medicare Fraud

In order to encourage individuals to report Medicare fraud, the government offers financial compensation to whistleblowers. Therefore, if you have information concerning Medicare fraud, you may be entitled to a financial reward. However, in order to make sure you report this information in an efficient and effective manner, you should contact a Medicare fraud whistleblower attorney for assistance. 

Contact a Medicare Fraud Whistleblower Attorney 

If you have evidence that a person or entity has committed Medicare fraud, you may be entitled to significant financial compensation. However, in order to be eligible for such compensation, you need to ensure that you report your information correctly. At Newman & Shapiro, we’ll help you gather and submit the documentation you need to file your Medicare fraud claim while ensuring that you remain legally protected. Regardless of the type of Medicare fraud information you want to report, you need an experienced attorney on your side to give you the best chance at recovery. Please contact us today for a consultation.