Qui Tam Representation For Medicare Fraud and Other Healthcare Fraud Whistleblowers
When you are contemplating taking action, you need a law firm that knows the healthcare system from the clinical to reimbursement perspective. We know the healthcare laws and regulations associated with your case. We share the frustration and moral outrage at what you have encountered. We will walk you through what you can expect step by step. Know that we speak the same language you do. We look forward to hearing from you. All communications are completely confidential. We have represented strong, courageous, and principled whistleblowers for over a decade and will be happy to review your case facts if they meet the firm’s requirements.
Healthcare Fraud involves violation of laws affecting patient care; false claims associated with the provision of health care such as medical care or services and items; medical diagnosis and treatment; drugs and biologicals; supplies, appliances, equipment, hospitals and other facilities; and violations of the Stark and/or Kickback statutes.
Medicare Fraud involving individuals 65 years and older and also those with disabilities covered by the Medicare program. The largest federally-funded healthcare program, medicare fraud occurs in various ways such as false claims regarding fees for services, cost reports, per diem, DRG’s, RUG’s, APC’s, capitation, outcomes, and more.
Hospital Fraud can take many forms, but typically involves the upcoding of diagnosis related group claims for inpatients; the upcoding of observation claims; the upcoding of ambulatory payment classifications for outpatients; the submission of false data to CMS contained in cost reports and other documents; failure to return over-payments; or the knowing violation of certain laws or regulations.
Part D provides a voluntary, outpatient prescription drug benefit for Medicare-eligible patients. Part D sponsors offer drug coverage either through stand-alone prescription drug plans(PDP) or through Medicare Advantage prescription drug (MA-PD) plans. Fraud involves false bids, false PDE data, and other false representations in documents submitted to CMS.
Medical Equipment Fraud involves or emanates from the approval, manufacture, marketing, distribution, or pricing of medical equipment. This includes implanted devices without FDA approval; manufacturing in violation of the CGMP’s; promotion for unapproved and dangerous uses, or patient populations; and so on.