Steps to Report Medicare Fraud
Thorough Preparation Makes Better Whistleblower Cases: 4 Steps to Report Medicare Fraud
Various U.S. governmental agencies encourage reporting Medicare fraud. The Department of Health and Human Services (HHS) Office of the Inspector General maintains a hotline at 1-(800) HHS-TIPS. The HHS and the Department of Justice created a website entitled “Stop Medicare Fraud” (www.stopmedicarefraud.gov). This website also refers to the HHS Office of Inspector General Hotline and also gives postal addresses and email addresses for reporting.
While well-intentioned, these may be inadequate vehicles for sophisticated insiders to report Medicare fraud and make something happen. The HHS tips hotline and the “Stop Medicare Fraud” website appear for the most part to be directed to Medicare beneficiaries themselves, not insiders with knowledge of complex fraud issues. Moreover, due to the large number, it is unknown how many of the thousands of reports of Medicare fraud are actually fully and properly investigated, and we suspect the percentage is not high.
Nolan & Auerbach, P.A. provides a complete evaluation/investigation for cases it accepts, and will provide initial feedback to determine whether or not fraud allegations are valid and qualify under the False Claims Act. Not every overpayment situation is necessarily fraud; some conduct resulting in overpayment to the Government is the result of oversight or negligence, or rogue employees. Unlike those situations, Nolan & Auerbach, P.A. is focused on intentional and widespread fraud that permeate the corporate culture.
Should you choose to contact us, or any other law firm, we suggest taking the following steps:
1. Document – Gather all relevant documentation which you are otherwise entitled to receive as part of your job duties. (Do not photocopy, download, or take any documentation to which you are not entitled to view, or is in violation of company policy or procedure);
2. Write a short summary of the fraud. This is important as the facts are fresh in your mind now, as opposed to years from now;
3. Make a list of all documents that are not in your possession but that you believe are relevant. Doing so now will be helpful to you to crystallize the facts whether or not you file a qui tam lawsuit;
4. Provide citations to any and all applicable regulations or laws and explain why you believe your company has violated them.
Should you provide this information to Nolan & Auerbach, P.A., we will engage in a thorough and confidential evaluation of the facts. We will follow-up on any relevant leads that you provide, and we will make sure that the law and regulations support a showing of the widespread fraud. We understand that a lot is at stake for you as a whistleblower, especially if you are a current employee.