Health Care Fraud Attorneys


Report Medicare or Medicaid Fraud. Be protected & rewarded for your courage.

One of the largest concerns for Americans is health care. Everyone will, at one point or another in their life, need to go to the doctor, be it for routine checkups, common illnesses, severe injuries or chronic diseases. The cost of medical care grows larger each year, forcing most American families to rely on insurance companies to help pay for prescriptions, doctor visits, in- and out-patient procedures, and extended hospital stays. Many people require help from the Government to help cover the cost of insurance, through Medicare, Medicaid, and the new provisions of the Affordable Care Act, meaning that the Government, and the taxpayer, is more invested than ever before in the constantly growing health care industry.

Considering the universal necessity of health care and the large costs related to medical procedures, equipment, pharmaceuticals, and highly-trained professionals, the health care industry is one of the largest in the US. With so much money available, the potential – and incentive – for fraud is substantial. Various schemes and deceitful activities are employed to swindle the Government out of funds, making the False Claims Act one of the most powerful tools to protect the taxpayer from fraudulent activity. In 2011 and 2012, 829 qui tam lawsuits were filed against hospitals and companies in the health care industry, with many resulting in multi-million or multi-billion dollar damage judgements.

Incentives can result in MILLIONS awarded to the whistleblower.

The problem of health care fraud has become so great a concern that the Center for Medicare and Medicaid Services (CMS) has proposed increasing the bounty awarded to whistleblowers under its Medicare Incentive Reward Program from the lesser of 10% of the damages or $1000, to 15% of the final recovery amount. This, in addition to the rewards available under the False Claims Act, provides relators who file medical qui tam lawsuits with substantial incentive to pursue actions against entities that defraud the US Government.

Hospitals and doctors have long been held as experts to whom medical decisions are best left, and while that is largely true, this lack of oversight exposes the Government to fraud on a regular basis. Hospitals can overcharge for procedures in order to increase their profit, or manipulate patient care and treatment options in order to pad Medicare or Medicaid claims, prescribing extraneous procedures for their patients or keeping them in the hospital for short unnecessary stays, increasing the patient’s medical bills and consequently charging their insurance for treatment they did not need. Some hospitals have gone as far as to charge Medicare and Medicaid for procedures that did not take place at all. Many others have been shown to have manipulated their contracts with doctors or used illegal insurance claims to provide physicians with kickbacks.

Report false claims to TRICARE/CHAMPUS (military health insurance) and the Veterans Administration.

Health care fraud is not just found in the private sector. Scams defrauding the government can be found in the health care systems established to help active and retired military. Although less frequent, false claims are submitted to TRICARE/CHAMPUS (military health insurance) and the Veterans Administration. In both cases, there are protections & incentives provided to the individual who brings these fraudulent activities to light.

The Government has long been reluctant to step in and tell doctors or hospitals how best to care for patients, but with the constant growth of the health care industry more is at stake than ever before. The effectiveness of the False Claims Act and medical qui tam lawsuits has encouraged the Government to pursue more oversight, acting through relators and whistleblowers to expose and redress instances of fraud or other illegal practices within the health care industry.

Please feel free to call (201) 585-9111 for an initial FREE CONSULTATION with a health care fraud lawyer in one of our offices, or in the privacy and convenience of your own home, during which we can explore how best to present your health care fraud case.