Medicare And Medicaid Fraud

In the United States, Medicare fraud is a general term that refers to an individual or corporation that seeks to collect Medicare health care reimbursement under false pretenses. There are many different types of Medicare fraud, all of which have the same goal: to collect money from the Medicare program illegitimately.The total amount of Medicare fraud is difficult to track, because not all fraud is detected and not all suspicious claims turn out to be fraudulent. According to the Office of Management and Budget, Medicare "improper payments" were $47.9 billion in 2010, but some of these payments later turned out to be valid.
Posts about Medicare And Medicaid Fraud
  • Tenet Exec INDICTED (Tenet Healthcare Whistleblower Post)

    … Tenet Healthcare is no stranger to fraud. It wasn’t that long ago that the for-profit hospital chain paid a record $514 million fine to the government. That case involved paying kickbacks for patient referrals. The patients in that case were pregnant, undocumented Hispanic women. Some thought the case ended when the company and its subsidiaries…

    Due Diligence- 18 readers -
  • Medically Unnecessary Therapy – Medicare Fraud Post

    … Earlier this week I was asked to comment on medically unnecessary therapy and Medicare fraud. The comments were for a Texas newspaper. Texas is a state that loses an estimated $3.2 billion each year just on Medicaid fraud. Add private insurance, Medicare and VA care and the annual cost of healthcare fraud in the Lone Star State approaches $1000…

    Due Diligence- 14 readers -
  • Out Your Boss, Get Paid $200k – Whistleblower Post

    … complaint, Dr. Barbour engaged in almost every type of Medicare and Medicaid fraud possible. For example, Dr. Barbour: altered the dates that procedures were performed to increase the amount charged for the services (unbundling); maintained improper cost reports; billed for more expensive procedures than necessary (upcoding) billed for serviees…

    Due Diligence- 12 readers -
  • Open Medicare Fraud Investigation: Dr Alberto Manahan

    … of Health and Human Services indicates that gang visits are an indicator of fraudulent billing. Is Dr. Alberto Manahan guilty of Medicare fraud? We need your help. Call attorneys Tim Granitz or Katherine Holiday at 414-258-2375 or email *protected email* This information is for investigations purpose only and will not be used without your permission…

    Due Diligence- 17 readers -
  • Fla. Lawyer Accused of Conflict of Interest, Legal Malpractice

    … a former client. But can there be a conflict of interest if a lawyer never even represented one of the parties? The answer may surprise you — Yes! And that is why Tampa attorney Barry Cohen is facing legal malpractice claims today. Ross Radiology’s Legal Malpractice Claim Against Barry Cohen Ross Radiology is a Florida based radiology practice…

    Legal Malpractice - Chris Trebatoski- 39 readers -
  • Florida Doc Tries Bankruptcy to Avoid Whistleblower Lawsuit

    … Green contended that Qamar engaged in “egregious acts of Medicare and Medicaid fraud through the performance of medically unnecessary, highly invasive, and therefore particularly dangerous heart procedures…” These procedures included cardiac catheterizations, peripheral vascular catheterizations and invasive aortic procedures. Why would a physician…

    Due Diligence- 48 readers -
  • The Dark Side of Medicaid Fraud – When Patients Suffer

    … Usually we post current news stories, including weekly posts about Medicare and Medicaid fraud. Today’s post is different. Although we often read how much money was awarded to whistleblowers or how many years in prison were handed down to the fraudsters, we rarely hear from victims. Unfortunately, healthcare fraud often involves needless human…

    Due Diligence- 17 readers -
  • New Jersey Says No to Patient Recruiter Schemes (Medicare Fraud Whistleblower Post)

    … services. It is only the one-on-one recruiting and use of bribes or payments that triggers the law. The use of patient recruiters and runners has always been a red flag for Medicare and Medicaid fraud. To date we have not seen a legitimate patient recruiter yet. Patient Recruiter Schemes Qualify for Whistleblower Awards Medicaid and Medicare fraud…

    Due Diligence- 22 readers -
  • Chicago MD Goes to Prison for Medicare Fraud

    …. Most Medicare fraud cases are prosecuted civilly. Under the False Claims Act, a whistleblower with inside information about Medicare and Medicaid fraud can earn an award of up to 30% of whatever the government collects from wrongdoers. To qualify for the award, one must generally be the first to file a sealed complaint in federal court detailing…

    Due Diligence- 16 readers -
  • Medicare Fraud Scheme – Billing Dead Patients?

    … and the False Claims Act Under the federal False Claims Act, whistleblowers who report Medicare fraud can collect up to 30% of whatever the government collects from the wrongdoers. To qualify, one generally must be the first to report and must have inside information about the fraud or scheme. To collect an award, whistleblowers must file a complaint…

    Due Diligence- 35 readers -
  • FLA Hospice Provider Settle Medicaid Fraud Case

    … provider just agreed to $3 million to settle federal Medicare and Medicaid fraud charges. Earlier this month Hospice of Citrus County agreed to pay $3 million to resolve claims that it billed for medically unnecessary services. Many needing end of life care are elderly and rely on Medicare or Medicaid for their healthcare needs. Federal and state…

    Due Diligence- 20 readers -
  • Court Allows Patient Records as Basis for False Claims Act Claim

    … is to protect patients, some healthcare providers have been using them as a shield against False Claims Act claims. Enacted during the U.S. Civil War, the False Claims Act remains the Justice Department’s number one weapon against Medicare and Medicaid fraud. Healthcare workers with inside knowledge of fraud involving Medicaid, Medicare or TriCare…

    Due Diligence- 17 readers -
  • Gov’t Intervenes in Nursing Home Medicare Fraud Case

    … to the alleged Medicare fraud, the whistleblowers claim that employees who did not go along with the scheme were harassed or threatened with termination. The False Claims Act contains strong anti-retaliation provisions to protect whistleblowers that step forward. If you have knowledge of Medicare or Medicaid fraud, give us a call. Our whistleblower clients…

    Due Diligence- 17 readers -
  • Lowlife of the Year (Medicaid Fraud Post)

    … Afraid of the Dentist? This Medicaid Fraud Story Will Really Scare You! Because we are fraud recovery and whistleblower lawyers, we see losers and lowlifes every day, especially in Medicare fraud cases. People like Dr. Farid Fatah convicted of giving people dangerous cancer drugs even though they didn’t have cancer. At least one patient…

    Due Diligence- 45 readers -
  • National Whistleblower Day – Finally!

    … to celebrate the contributions of everyone who has stepped forward. Hopefully there will be a celebration each year in Washington on this date. The public needs to hear the stories and so much more needs to be done to fight greed, waste and fraud. As I write this post, the FBI claims that Medicare and Medicaid fraud costs Americans $80 billion per…

    Due Diligence- 34 readers -