Your Most Common Questions Answered About Filing Healthcare Frauds, Whistleblower Rights and Rewards

Healthcare fraud occurs when an individual or entity, such as a physician, hospital, medical device manufacturer, vendor, pharmacy or home health agency knowingly submits a false claim or makes a misrepresentation of facts to obtain payment from a state or federal government program, such as Medicare, Medicaid or Tricare.

Medicare and Medicaid frauds can occur in a variety of ways, such as:

• Upcoding or billing for a more expensive service than the one which was actually performed.
• Billing homebound patients and government benefits programs for services that were never rendered.
• Falsifying a diagnosis with the procedures that weren’t required.
• Drug pricing fraud wherein a healthcare provider dishonestly prescribes a medication to benefit from sales.
• Unbundling or billing each stage of a procedure as if it were a different one.
• Billing for non-covered service as a covered service.
• Counterfeit drug fraud wherein a physician knowingly pushes altered or fake prescription drugs.
• Overutilization of services, kickbacks and gifts.
• Drug diversion abuse in which case the physician doesn’t administer medication but rather keeps it for personal profit.

In addition to Medicare frauds, some practitioners resort to healthcare abuse by involving in practices that are inconsistent with acceptable practices. It is also a fraud if claims are submitted by the home healthcare service that are not compliant with the government programs.

Billions of dollars in healthcare frauds remain to be detected

Every year, billions of dollars of taxpayer money is wasted through healthcare frauds in the United States with billions of dollars more remaining undetected. Government and regulatory authorities are limited in their abilities to discover every instance of fraud or malfeasance in healthcare programs. To protect the integrity of healthcare programs, all healthcare frauds should be reported.

How to pursue Medicare and Medicaid claims

Medicare frauds can be pursued under the False Claims Act (FSA) by anyone with the knowledge of fraud that has not already been publicly disclosed. A whistleblower can be anyone with insights about the frauds, such as an employee, supplier, pharmacy benefits manager, vendor, etc. They can contribute greatly towards curbing Medicare and Medicaid frauds and unethical practices at the workplace by reporting the matter to a whistleblower law firm that can help you with how to report healthcare frauds as it is vital to blow the whistle the right way to become eligible for rewards. Whistleblower lawyers at Brown LLC have extensive expertise in whistleblower suit procedures to pursue your case in the strongest way.

Healthcare frauds result in increased insurance premiums for all

Government, regulators and people, all are harmed in furtherance of these frauds. Besides endangering people’s access to healthcare insurance, Medicare and Medicaid frauds result in increased insurance premiums and out-of-pocket expenses for everyone.

Violators of FSA are liable for three times the dollar amount that the government is defrauded, in addition to civic penalties. A qui tam plaintiff or whistleblower can receive 15 to 25 percent in rewards of the total recovery from the defendant. If the whistleblower successfully resolves the case without the government’s assistance, then the rewards could be higher.

You get monetarily rewarded for being a whistleblower

However, to receive your reward, merely informing the government of the fraud is not enough. You need to file a lawsuit through your whistleblower attorney who will help you in how to report a Medicare fraud the right way. You receive a percentage of the dollar amount when the government recuperates the money from the defaulter due to you lawsuit.

Brown LLC whistleblower law firm can help you in getting your share of whistleblower reward for your courage to blow the whistle to report a healthcare fraud. The premiere whistleblower law firm has recovered tens of millions of dollars for their clients through favorable settlements in the whistleblowing cases nationwide with a former FBI Special Agent leading the way for you. Their accomplished team of lawyers has successfully litigated matters in state and federal courts, sometimes obtaining the maximum permissible relief. Besides whistleblower cases, Brown LLC’s practice areas include complex litigation, bad products, serious injuries, and more.

Protecting you from retaliation

As a whistleblower, you are protected from retribution or retaliation by your employer, such as being threatened, harassed, demoted, discharged or attacked for bringing out the instances of fraud, waste, abuse and off-procedure violations. If it has happened to you, Brown LLC’s whistleblower lawyer will file a case against your employer, seeking compensation for the lost pays, reinstatement, etc. Your whistleblower attorney will make sure that you are not short-changed for the contribution of your whistleblower information.

Telling a whistleblower law firm from a referral service

Choosing the right whistleblower law firm to represent your claim is an important decision that needs to be taken carefully. You may find many law firms claiming to have won many large cases with large amounts in recoveries but fail to mention that they were not whistleblower cases. A trusted whistleblower law firm will have whistleblower cases listed on its site that it actually filed, litigated and won.

Make sure that you hire a whistleblower lawyer who will work on your qui-tam lawsuit. Look for the name of the whistleblower lawyers on the whistleblower law firm’s website, If there aren’t any names, it’s a red flag that it’s a referral service that will sell your case to a whistleblower law firm who is willing to pay a fee. Also, if there is no physical address on the site, then it is likely to be a referral service.

Also, remember that whistleblower cases can require multiple resources, so your whistleblower law firm should have attorneys for other practice areas also such as complex litigation, product liability, serious injuries, etc. who can help you with your case if the attention of multiple attorneys is needed.