Healthcare Fraud Against the Government
The Institute of Medicine has reported that over $75 billion in healthcare fraud occurs in the United States annually. In 2011, the United States recovered only approximately five percent of that fraud-about 4 billion-with the remainder of the fraud being paid for by American taxpayers.
Recognizing this drain on the economy, Congress and federal agencies have passed statutes and regulations that are targeted at preventing waste, fraud and abuse in the healthcare arena. With the Supreme Court confirming the constitutionality of the Affordable Care Act, the United States Government and whistleblowers have a new arsenal of regulations to assure that funds are not being stolen from the American public through overpayments.
But, the federal government can't do it alone. It needs the help of courageous Americans who know of the fraud, disapprove of the fraud and want justice for the American public. The New England Journal of Medicine has reported that of the healthcare fraud cases filed, 90% are filed by private whistleblowers in the name of the Government.
Healthcare fraud can come in a variety of contexts. Some of these include:
- Retaining Medicare overpayments more than 60 days after learning about the overpayment (so-called, "reverse false claims")
- Paying physicians for referrals that are based on the volume or value of services in violation of the Stark law
- "Off-label" or illegal marketing - promoting a drug for an unapproved use
- Illegal marketing of prescription drugs or services through kickbacks in violation of the Anti-Kickback Statute
- "Swapping" - agreeing to a discounted rate for a particular service under Medicare Part A in exchange for all of the business at full-price for Medicare Part B
- Providing tainted pharmaceuticals
- "Upcharging" - billing for a higher-cost service than the one provided
- Billing for in-home healthcare services that were not rendered
If you know of fraud in the healthcare arena and want to hold those entities accountable, Butler Wooten & Peak LLP, has the experience to take your case from filing a complaint under seal to trial. We have recovered in excess of $150 million dollars for our clients and the United States Government and we are not afraid of a fight.
Contact us today so that Butler Wooten & Peak LLP, can begin investigating your potential qui tam case so that you, as the whistleblower, and the American public can receive the compensation you deserve.