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Report Fraud The purpose of the qui tam provisions of the False Claims Act is to encourage private individuals who are aware of cost report fraud, or any other type of fraudulent acts being perpetrated against the government to bring such information forward. Cost report fraud typically occurs with Medicare Part A providers, such as hospitals, nursing homes and home health agencies. Most providers are now paid based on the prospective payment system, and therefore much less financial impact occurs if cost report entries are falsified. Even so, some areas remain fully cost-based. Some cost report fraud scenarios include:
The States of California, Florida, Texas and New York lead Medicare cost reimbursement provided to the U.S. hospital and other provider systems. Some providers still commit cost report fraud due to a lack of commitment to compliance. Medicare Part A cost report fraud is relatively easy to get away with because of the lack of oversight and enforcement resources. Whistleblowers who have tried to correct cost report fraud internally to no avail (or those who can't) have the incentive of the qui tam provisions of the False Claims Act should they choose. Nolan & Auerbach and its experts provide experienced representation and knowledgeable expert consultants in this very specialized area of healthcare reimbursement whistleblower representation. Toll Free: 800-FRAUD 04 Offices: 435 North Andrews Avenue, Suite 401, Ft Lauderdale, FL 33301 Home | About
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