This article addresses how to report Medicare fraud or how to report Medicaid fraud.
Medicare fraud and Medicaid fraud is on the rise and is hurting our economy and healthcare. This website explains the process of reporting Medicare fraud or Medicaid fraud and how to receive a monetary whistleblower reward.
The False Claims Act pays whistleblowers a reward of between 15 and 25 percent of what the government collects based on your report of Medicare fraud (or Medicaid fraud). To receive a whistleblower reward, you must actually hire an attorney (which is on a contingency basis) to file a lawsuit against the hospital or healthcare provider that is committing Medicare fraud or Medicaid fraud. To convince the government to take a Medicare fraud case requires detailed and specific evidence that the healthcare provider was committing fraud against Medicare or Medicaid. It is not enough to report fraud to a hotline or have a general knowledge of Medicare or Medicaid fraud. Usually, rewards are paid to whistleblowers who worked for the hospital or healthcare provider who committed the fraud because they have knowledge of the fraud scheme, and receive a reward even if they were asked to participate in defrauding Medicare or Medicaid. The government pays huge monetary rewards when the whistleblower has inside information that proves the Medicare or Medicaid fraud.
Example of reporting Medicare fraud and receiving a whistleblower reward
Suppose a hospital wants to defraud Medicare and Medicaid. One common ways to defraud Medicare or Medicaid is upcoding, which means bill at a higher code than allowed, such as billing for treating pneumonia when the person had a cold. Another common way to defraud Medicare or Medicaid is to bill for services that are not necessary or provided, such s way order unnecessary tests or to bill for tests not actually done. Hospitals cheat insurance companies in similar ways, but the reward program only pays rewards for reporting fraud against Medicare of Medicaid or other government programs. Therefore, if a hospital is upcoding for most of its patients, the reward program would only look at the fraud against Medicare or Medicaid or other government programs. Because Medicare and Medicaid often are a large part of a hospital’s practice, the amount of fraud gets high pretty fast.
The key to obtaining a reward for reporting Medicare fraud is to have proof and then report widespread fraud against Medicare or Medicaid, and not an isolated instance because the reward is based upon how much money the government collects back from the entity that is defrauding Medicare or Medicaid. It is not usually worth your time to report fraud if you do not have evidence that the entity committed fraud against Medicare or Medicaid on a large scale.
How to report Medicare fraud and get a reward
Mr. Hesch would be pleased to review your information and help you determine if you have the right kind of information and how to report Medicare fraud or Medicaid fraud and receive a whistleblower reward.
The rest of this website walks you step-by-step through the process of how to report Medicare fraud or Medicaid fraud and shows you how you can apply for a monetary reward.
See the link below “Do I have a case” to have Mr. Hesch review your potential whistleblower reward case for Medicare fraud or Medicaid fraud. See the link below “Report Fraud” to learn more about the government’s whistleblower reward program relating to Medicare and Medicaid fraud.
Click on the following link for a pdf version of this article: how to report medicare fraud and get reward