Reporting Medicare Part D fraud or Pharmacy benefit fraud
This article addresses how to get a whistleblower reward for reporting pharmacy benefits fraud when a pharmacy commits fraud, which is a type of Medicare Part D fraud.
Why report a pharmacy that is cheating or defrauding Medicare Part D (Pharmacy benefit fraud)?
Medicare is being exploited by healthcare providers, including pharmacies, who are cheating or committing fraud. It is believed that as much as 10% of Medicare/Medicaid bills are fraudulent. Pharmacies cheating under Medicare Part D is one culprit. When you report pharmacy benefit fraud you help save Medicare/Medicaid prescriptions that are needed and necessary.
Examples of pharmacy benefit fraud under Medicare Part D
There are three main types of Part D fraud or pharmacy benefit fraud in which a whistleblower may be entitled to a significant monetary reward. The first type of pharmacy benefit fraud is when a pharmacy bills for drugs or other pharmacy services that were not provided. Perhaps the pharmacy filled one prescription for a Medicare Part D recipient, but billed Medicare Part D for an additional prescription that was not fulfilled.
A second type or example of pharmacy benefit fraud under Medicare Part D is when a pharmacy alters the prescription to obtain a higher payment amount. For instance, the pharmacy fills 10 tablets to a Medicare Part D recipient, but bills Medicare for 30 or 60 pills.
A third type or example of pharmacy benefit fraud occurs when a pharmacy billing for brand-name drugs when generics are dispensed. For instance, the pharmacy fills 30 tablets of a generic drug to a Medicare Part D recipient, but bills Medicare for the price of the brand name drug.
There are other variations or types of pharmacy benefit fraud, and a pharmacy cheating or defrauding Medicare Part D will go to great lengths to disguise or conceal the fraud.
Rewards for reporting fraudulent billing of pharmacy benefits under Medicare Part D
The government is asking you to report pharmacy benefit fraud under Medicare Part D. In fact, the government is offering significant whistleblower rewards. To receive a reward for reporting Medicare Part D fraud by cheating with regard to pharmacy benefits, you must follow the exact whistleblower reward procedures required in the reward statute. Following the reward program’s reporting requirement is also the best way to help ensure that Medicare opens an investigation. The following addresses how to report pharmacy benefit fraud under Medicare Part D.
How much reward for reporting fraudulent billing of unnecessary blood tests
The size of any potential whistleblower reward is tied to the amount Medicare/Medicaid recovers based on your allegations of pharmacy benefit fraud under Medicare Part D. The reward program pays between 15% and 25% of what Medicare gets back from the pharmacy company cheating or overcharging Medicare Part D. That means, if a pharmacy company cheated Medicare by $10 million, the reward would be between $1.5 million and $2.5 million.
If you work for a pharmacy company that is cheating or defrauding Medicare, you may be eligible for a reward for reporting it. For instance, if a large pharmacy company or chain of pharmacy companies routinely commit fraudulent schemes, it adds up pretty quickly in overbilling Medicare.
Tips for reporting pharmacy benefit fraud under Medicare Part D
Below are just two important tips for how to report fraudulent billing of pharmacy benefits under Medicare Part D.
First, it isn’t enough to simply call a hotline to report pharmacy benefit fraud under Medicare Part D to get a reward. That’s because the whistleblower reward procedures prohibit paying rewards based on a tip. Rather, the reward program requires that you use an attorney for reporting fraudulent billing of pharmacy benefits under Medicare Part D.
It’s important to carefully select the right attorney because they must strictly follow the exacting procedures of the reward statute to get a reward for reporting pharmacy benefit fraud under Medicare Part D. (However, experienced attorneys handling fraudulent billing of pharmacy benefits under Medicare Part D take such fraud cases on a contingency basis and charge only a percentage of any whistleblower reward.)
Second, your lawyer must report the fraudulent billing of pharmacy benefits under Medicare Part D in great detail and describing how the pharmacy defrauded Medicare Part D. The government turns away most reward applications, so you need to hire a lawyer that has experience with Medicare reward cases.
How to report fraudulent billing of pharmacy benefits under Medicare Part D
This rest of this website (plus the whistleblower reward books authored by Mr. Hesch) take you step-by-step through the entire process of reporting fraudulent billing pharmacy benefits under Medicare Part D and how to report pharmacy benefit fraud under Medicare Part D to get a whistleblower reward.
Mr. Hesch worked over 15 years in the Civil Fraud Section of the U.S. Department of Justice in Washington, D.C. handling Medicare fraud cases. This is the office with nationwide authority over the nationwide whistleblower reward program. Mr. Hesch is available to review your pharmacy benefit fraud case and help determine whether you should and how to report fraud against Medicare by fraudulent billing pharmacy benefits under Medicare Part D.
The link at the bottom of the below “Do I have a case” shows you how to ask Mr. Hesch to review your pharmacy benefit fraud case in confidence and how to get a reward for reporting fraudulent billing of pharmacy benefits under Medicare Part D.
The link at the bottom of the below “Report Fraud” has more information regarding how to get a reward for reporting fraud against Medicare or Medicaid by fraudulent billing of pharmacy benefits under Medicare Part D.
Click on this link to read this article in pdf format: How to report Medicare Part D Fraud (Pharmacy benefits) and obtain a whistleblower reward PDF version