Healthcare Fraud is Widespread, but Whistleblowers can Help Stop it

ken-treloar-385255-copy-300x200Medicare and Medicaid are taxpayer-funded healthcare programs instituted for the purpose of ensuring that all Americans have access to basic health services. Fraud on the part of health care providers is a major threat to these programs and to the health of millions of Americans who benefit from their services. Every year, physicians and other members of the healthcare industry enrich themselves by diverting funds from Medicare and Medicaid to themselves and by fraudulently billing these publicly funded programs. Whistleblowers who have helped bring legal action against purveyors of healthcare fraud have helped the nation recover billions of dollars for healthcare.  If you are aware of healthcare fraud at your workplace, contact an attorney to discuss filing a qui tam lawsuit.

How Big a Problem is Healthcare Fraud?

The Department of Justice collects data on healthcare fraud, and the figures are alarming. For 2014, the most recent year for which the DOJ has published statistics, it is clear that healthcare fraud was widespread, but that the government, with the help of whistleblowers, was taking effective measures to stem it.

  • In the 2014 fiscal year, whistleblowers filed 165 complaints against alleged perpetrators of healthcare fraud.
  • 353 defendants were charged with Medicare fraud. The combined total of their fraudulent bills to Medicare amounted to $830 million.
  • 248 defendants received prison sentences for healthcare fraud convictions. The average length of their prison sentences was between four and five years.
  • 304 defendants charged with healthcare fraud entered guilty pleas.
  • 41 defendants were found guilty of healthcare fraud at jury trials.

The Medicare Fraud Strike Force began in 2007, and it has prosecuted more than 900 Medicare fraud cases against defendants who fraudulently billed Medicare more than $6.5 billion. More than two thousand defendants were charged with fraud, and more than three quarters of these received criminal penalties either after pleading guilty or following a conviction by jury trial.

Fight Healthcare Fraud with Qui Tam Lawsuits

The False Claims Act (FCA) holds healthcare providers liable for submitting false health claims to Medicare, Medicaid, or other entities that might reimburse them. It contains a provision for qui tam lawsuits; a qui tam lawsuit is a civil lawsuit filed by the person who became aware of the fraud (the whistleblower) against the person who committed the fraud. Because whistleblowers file these suits at great risk to their professional futures, they are eligible for courts to award them a portion of the money that the court obliges the defendant to pay.

Contact Greg Brod About Healthcare Fraud Lawsuits

Whistleblowers who alert the government about healthcare fraud are taking a risk personally but fulfilling an important duty to the nation. A qui tam lawsuit can offer you legal and financial protection in the aftermath of a whistleblower action. If you work in healthcare and are aware of FCA violations at your workplace, a qui tam lawsuit could be the best course of action. Contact Greg Brod in the San Francisco area to discuss a possible qui tam lawsuit.

(image courtesy of Ken Treloar)