Reporting End-Stage Renal Disease case mix fraud (ESRD case mix fraud)

This article shows you how to get a reward for reporting fraud against Medicare or Medicaid by reporting End-Stage Renal Disease case mix fraud (ESRD case mix fraud)

Defining End-Stage Renal Disease case mix fraud (ESRD case mix fraud)

The End-Stage Renal Disease (ESRD) is one only a few condition-specific diseases that has a Medicare program entitlement or automatic Medicare coverage. Healthcare providers charge Medicare $30 billion a year to treat End-Stage Renal Disease (ESRD), which is a significantly higher rate of payment than for other diseases. To try to stem potential End-Stage Renal Disease (ESRD) fraud, effective January 1, 2011, the Centers for Medicare and Medicaid Services (CMS) introduced a new “bundled” payment system. Medicare providers are supposed to be reimbursed as a single payment to dialysis facilities for each dialysis treatment covering all renal dialysis services, which includes drugs and diagnostic laboratory tests. However, the payment is based upon a case mix.

It is fraud to conceal or inaccurately report the case mix of End-Stage Renal Disease (ESRD) because Medicare will increase the payment based upon case mix figures or data.

Other forms of End-Stage Renal Disease fraud (ESRD fraud)

Another form of End-Stage Renal Disease (ESRD) fraud consists of wrongful use of erythropoiesis stimulating agents pertaining to patient red blood cell counts because this is an aspect of Medicare billing that affects the amount of reimbursement. Basically, any billing for End-Stage Renal Disease (ESRD) that is not accurate constitutes fraud.
This rest of this article outlines the basics for how to report End-Stage Renal Disease (ESRD) fraud and how to apply for a whistleblower reward for reporting End-Stage Renal Disease (ESRD) fraud against Medicare or Medicaid.

Tips for reporting End-Stage Renal Disease (ESRD) fraud

Here are some tips for how to report End-Stage Renal Disease (ESRD) fraud.

First, you can’t simply call the government or a hotline to report End-Stage Renal Disease (ESRD) fraud. To be eligible for a reward for reporting End-Stage Renal Disease (ESRD) fraud you must use an attorney (on a contingency basis consisting of a portion of any whistleblower reward) to file qui tam suit under the False Claims Act. Your attorney must follow the exact procedures the whistleblower reward statute to get a reward for reporting End-Stage Renal Disease (ESRD) fraud. Therefore, it is key that you select an attorney experienced with handling reward applications for upcoding fraud and Medicare fraud cases.

In addition, you need to report in detail how the hospital, doctor or healthcare provider is engaged in the End-Stage Renal Disease (ESRD) fraudulent scheme to cheat Medicare. The government needs your help in uncovering End-Stage Renal Disease (ESRD) fraud. However, because most whistleblower reward applications lack specific proof or contain other defects, the government turns away 75% of reward claims. Again, that’s why selecting an experienced attorney that has handled Medicare fraud cases is important.

How much reward for reporting End-Stage Renal Disease (ESRD) fraud?

The size of a whistleblower reward is determined by the size of the Medicare End-Stage Renal Disease (ESRD) fraud. The reward is between 15% and 25% of the amount of money the government collects back to Medicare from the hospital, doctor or healthcare provide that is cheating and being overpaid by End-Stage Renal Disease (ESRD) fraud.

How to report End-Stage Renal Disease (ESRD) fraud

This website (and the books authored by Mr. Hesch) walk you step-by-step through the entire process of reporting End-Stage Renal Disease (ESRD) fraud against Medicare and shows you how to report End-Stage Renal Disease (ESRD) fraud to obtain a whistleblower reward.

Mr. Hesch has considerable experience with investigating Medicare fraud against the federal government while working for 15 years at the Civil Fraud Section of the U.S. Department of Justice in Washington, D.C., which is the office with nationwide authority over the whistleblower reward program. He is ready to review your information and show you whether and how to report fraud against Medicare by End-Stage Renal Disease (ESRD) fraud schemes.

The link below “Do I have a case” shows you how to ask Mr. Hesch to review your potential Medicare End-Stage Renal Disease (ESRD) fraud case and how to get a reward for reporting End-Stage Renal Disease (ESRD) fraud schemes.