Reporting inpatient hospital fraud for billing for short hospital stays or same day discharges and readmission
It is fraud for a hospital to bill Medicare Part A for “in patient” beneficiary stays that really should have been billed as outpatient or outpatient with observation services. Hospitals also defraud or cheat Medicare or Medicaid by billing for same day discharges and readmission as inpatient services.
Report Medicare Fraud by hospitals billing same day discharges and readmission as inpatient services
Some hospitals engage in the fraudulent practices of billing Medicare separately for related discharges and readmissions within the same day. For instance, if a patient returns to the hospital on the same day relating to the same symptoms or same acute care, the hospital must not bill for two separate treatments, but must combine both into one bill. It is Medicare fraud to bill inpatient same-day discharges and readmissions in two bills instead of just once.
Needless to say, the amount of the Medicare bill is significantly higher if the hospital bills twice for the same condition as if it bills for all the treatment occurring in a single day.
To properly report fraudulent schemes of billing Medicare or other healthcare programs for inpatient status for or same day treatment and to be eligible for a whistleblower reward you cannot simply call a Medicare fraud hotline. Rather, to apply for a reward for reporting the inpatient fraudulent billing you must use an attorney (on a contingency basis) to file qui tam suit under the False Claims Act. Your attorney must follow the exact procedures of the whistleblower reward statute to get a reward for reporting fraudulent billing of inpatient status.
In addition, you need to report in detail how hospital is engaged in a fraudulent scheme to cheat Medicare by improperly billing inpatient status. The government needs your help in uncovering fraudulent billing of inpatient status by hospitals. But, because most whistleblower reward applications lack specific proof or contain other defects, the government turns away 75% of reward claims. That’s why selecting an experienced attorney that has handled Medicare fraud cases is important.
How much reward for reporting a hospital improperly billing of inpatient status?
The amount of a whistleblower reward for reporting fraudulent billing of inpatient status is based upon the amount of money the government recovers back, and the reward is between 15% and 25% of what the government collects back from the hospital cheating Medicare by billing for inpatient status. In the example above where a hospital repaid $26 million, the amount of a whistleblower reward could be between $3.9 million and $6.5 million.
How to report a hospital falsely billing inpatient status
This website (plus the whistleblower reward books authored by Mr. Hesch) take you step-by-step through the entire process of reporting a hospital falsely billing inpatient status and fraud against Medicare, and shows you how 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 now represents whistleblowers and confidentially reviews information to determine whether and how to report fraud against Medicare by a hospital falsely billing inpatient status.
The link at the bottom of the page below “Do I have a case” shows you how to ask Mr. Hesch to review your allegations of short stay hospital fraud or same day readmission fraud and how to get a reward for reporting bid rigging fraud.
The link at the bottom of the page below “Report Fraud” has more information regarding how to get a reward for reporting short stay hospital fraud or same day readmission fraud against the government.