Reporting blood test fraud against Medicare
This article addresses how to get a whistleblower reward for reporting a hospital or laboratory for overbilling Medicare by ordering blood tests that were not needed.
Why report hospitals or other healthcare providers ordering unnecessary blood work (Medicare fraud)?
Our healthcare system is being exploited by those who cheat or defraud Medicare or Medicaid. It is believed that 10% of Medicare/Medicaid bills are fraudulent. A hospital, clinic or other healthcare provider ordering unnecessary blood tests, blood work, or other lab tests is one culprit. When you report Medicare fraud due to ordering unnecessary blood tests you help save Medicare/Medicaid for tests that are needed and necessary.
Examples of a laboratory ordering unnecessary blood tests and cheating Medicare
A national laboratory agreed to pay the federal government and state Medicaid programs over $100 million to settle allegations that the lab billed Medicare/Medicaid for blood tests it added to a standard panel of blood chemistry tests despite the fact that the doctors hadn’t ordered the extra tests and these extra blood tests were medically unnecessary.
A whistleblower brought the allegations and reported the blood test fraud, and received a multi-million dollar whistleblower reward.
Example of a hospital ordering unnecessary blood tests and defrauding Medicare
A large hospital paid close to $100 million to settle allegations that the hospital improperly added blood tests that the treating doctors didn’t believe were needed. That case was also brought by a whistleblower who received a multi-million dollar reward for reporting the blood test fraud. The whistleblower alleged that the hospital developed a scheme whereby each time a doctor ordered a complete blood count (CBC) for a patient (either in the emergency room or in outpatient services) the hospital billed Medicare for some additional blood chemistry tests, known as “CBC indices.”
Anytime a lab or hospital orders tests that are not medically necessary, it is Medicare fraud. Medicare rightfully only reimburses a hospital, laboratory or healthcare provider for medically necessary tests. However, many hospitals cheat by either asking the doctors to order more tests than needed so they can bill Medicare, or commit Medicare fraud by claiming to conduct blood tests that were not performed.
Rewards for reporting fraudulent billing of unnecessary blood tests or blood work
The government is asking you to report blood tests billed to Medicare/Medicaid that are not medically necessary. In fact, the government is offering significant whistleblower rewards. To receive a reward for reporting Medicare fraud by billing for unnecessary blood tests, you must follow the exact whistleblower reward procedures spelled out in the statute. Following the reward program’s reporting requirement is also the best way to get Medicare to open an investigation.
The rest of this article addresses how to report fraudulent billing of unnecessary blood tests and how to get a whistleblower reward for reporting medically unnecessary blood work being billed to Medicare or Medicaid.
Tips for reporting fraudulent billing of unnecessary blood tests
Below are just two important tips for how to report fraudulent billing of unnecessary blood tests.
First, it is not enough to call a hotline to report fraudulent billing of unnecessary blood tests to get a reward. In fact, the whistleblower reward procedures prohibit paying a reward based on a tip. Rather, the reward program requires that you use an attorney for reporting fraudulent billing of unnecessary blood tests to Medicare.
It’s important to carefully select the right attorney because they must strictly follow the exacting procedures in order to get a reward for reporting fraudulent billing of unnecessary blood tests. (The good news is that experienced attorneys handling fraudulent billing of unnecessary blood tests cases and applying for whistleblower rewards 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 unnecessary blood tests in great detail and describing how the hospital, lab or other healthcare provider defrauded Medicare by ordering blood tests that were not medically necessary. The government turns away most reward applications, so you need to ensure you hire a lawyer that has experience with reward cases.
How much reward for reporting fraudulent billing of unnecessary blood tests
The size of any whistleblower reward is based upon the amount Medicare/Medicaid recovers based on your allegations of fraudulent billing of unnecessary blood tests. The reward program pays between 15% and 25% of what Medicare gets back from the hospital or lab cheating or overcharging the government.
How to report fraudulent billing of unnecessary blood tests
This rest of this website (plus the whistleblower reward books authored by Mr. Hesch) walk you step-by-step through the process of reporting fraudulent billing of unnecessary blood tests and how to report fraudulent billing of unnecessary blood tests 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 whistleblower reward program. Mr. Hesch is available to review your case and help determine whether you should and how to report fraud against Medicare by fraudulent billing of unnecessary blood tests.
The link below “Do I have a case” shows you how to ask Mr. Hesch to review your Medicare fraud case and how to get a reward for reporting fraudulent billing of unnecessary blood tests.
The link below “Report Fraud” has more information regarding how to get a reward for reporting fraud against Medicare or Medicaid by fraudulent billing of unnecessary blood tests.