Suspect Medicare and Medicaid Prescription Drug Billing Fraud?
Don’t stay silent. We help brave whistleblowers speak out against prescription overbilling fraud in North and South Carolina.
In recent years, Medicare and Medicaid prescription drug billing fraud has emerged as a critical issue costing U.S. taxpayers millions of dollars while jeopardizing patient care. When a healthcare provider cheats the system by purposely overbilling Medicare or Medicaid for prescription drugs, they are violating the False Claims Act and can (and should) be held accountable.
Whistleblowers can help the government fight Medicare and Medicaid overbilling fraud.
Do you know of a hospital, nursing home, or pharmacy that bills for more expensive medications than it actually dispenses or charges for a higher quantity of drugs than provided?
Have you observed a medical provider prescribing medications that aren’t necessary?
These are types of prescription overbilling fraud, and we can help you blow the whistle to try to stop it.
At Carolina Whistleblower Attorneys, we’re experienced in pursuing whistleblower claims in North and South Carolina for Medicaid and Medicare billing fraud. If you have observed this type of prescription drug overbilling behavior, we can help you determine if you have a whistleblowing case. Contact us today at 1-888-292-8852 for a free, confidential discussion that can give you peace of mind and help you decide how you want to proceed.
What is overbilling for prescriptions under Medicare/Medicaid?
Overbilling for prescriptions under Medicare/Medicaid is a form of healthcare fraud where pharmacies, healthcare providers, or other entities intentionally charge these government programs more than they should for prescription medications. This fraudulent practice can take several forms and is considered a type of healthcare fraud.
Prescription overbilling fraud not only costs taxpayers millions of dollars annually, but it also compromises the integrity of these essential healthcare programs. It can lead to inflated drug prices, reduced benefits for legitimate patients, and ultimately undermine the sustainability of Medicare and Medicaid.
What are some examples of Medicare and Medicaid prescription drug billing fraud?
Fraudulent healthcare providers have discovered many ways to overbill Medicare and Medicaid for prescriptions, including:
- Billing for drugs not dispensed by submitting claims for medications that were never provided to the patient
- Billing for higher-priced drugs, sometimes referred to as upcoding, which involves dispensing a generic drug but billing for the more expensive brand-name equivalent
- “Short-filling” or “short-counting” prescriptions, which is done by dispensing a smaller quantity of medication than prescribed and charging for the full amount
- Unauthorized medication dispensing, which can include dispensing prescription medication without proper authorization or outside legal and professional guidelines. (Note: A recent manifestation of this type of fraud is the “pill mill” – a medical practice, clinic, or pharmacy that operates primarily to prescribe and dispense controlled substances such as opioids without legitimate medical justification.)
- Prescribing or dispensing unnecessary medication, including costly compounded medications and creams
- Prescription splitting, or dividing a single prescription into multiple smaller ones to increase the number of dispensing fees
- Phantom prescriptions, which include billing for prescriptions for non-existent patients
- Unauthorized auto-refilling, or automatically refilling prescriptions without the patient’s request or need
If you suspect or have information about a healthcare service provider intentionally committing Medicare and Medicaid prescription drug overbilling fraud, contact us for a free and confidential case evaluation by calling 1-888-292-8852 now.
How can I report suspected Medicare/Medicaid prescription drug overbilling fraud, and how can a whistleblower attorney help?
A whistleblower attorney can help you report Medicare and Medicaid prescription drug fraud by filing a qui tam lawsuit on behalf of the government under the False Claims Act. This may involve:
- Evaluating the evidence
- Building your case
- Filing a qui tam lawsuit under the False Claims Act
- Coordinating with the government in the investigation of the prescription fraud allegations
- Negotiating with the government to try to get you the maximum award in a successful case – up to 30% of the government’s recovery
- Advocating on your behalf throughout the whistleblowing process
Why is overbilling for prescriptions considered fraudulent?
Overbilling government healthcare programs for prescription drugs is considered fraudulent because it involves intentional deception for illegal financial gain. Medicare and Medicaid prescription drug overbilling fraud undermines the integrity of healthcare systems and often violates laws and regulations designed to ensure accurate billing and fair use of resources.
Overbilling for prescription drugs scams increase costs for the public, undermine patient care, and erode patient confidence in healthcare providers.
How Carolina Whistleblower Attorneys can help you fight Medicare and Medicaid services prescription drug fraud
If you suspect Medicaid or Medicare prescription drug fraud and are considering taking steps towards exposing it, it’s important to know your rights. We can help you. Our whistleblower team is led by former U.S. Attorney Bill Nettles. During his tenure, South Carolina became one of the top four states in the nation for whistleblower recoveries.1,4
Our mission is to expose fraud against the government, and we stand with those who have the courage to report all types of medical billing fraud involving Medicare and Medicaid. Our client success stories prove our dedication to seeking justice.1,4
We operate on a contingency fee basis, which means we cover all the costs of building your case, and you don’t pay a penny unless we win an award for you – guaranteed.2 With our You-First Policy, your interests come first every step of the way.
Whistleblowers play a critical role in identifying prescription drug overbilling schemes. If you suspect Medicaid or Medicare overbilling fraud, let’s have a confidential conversation. We can answer your questions and help you explore your options. The consultation is free, and there’s no obligation.
Contact us online or call 1-888-292-8852 today!
Awards we’ve won
For standards of inclusion for awards listed, visit bestlawyers.com, thenationaltriallawyers.org, superlawyers.com, farrin.com/business-nc-power-list, and millondollaradvocates.com. National Trial Lawyers Top 100 designation is for 2025. Regarding the Million Dollar Advocates Forum, we do not represent that similar results will be achieved in your case. Each case is different and must be evaluated separately. Firm award is for the Law Offices of James Scott Farrin. Attorney awards are for attorneys with the Law Offices of James Scott Farrin.
Contact the Carolina
Whistleblower Attorneys
If you’re wondering if it’s a good idea to speak with a whistleblower lawyer about what you know, let us set the record straight.
- Corporate ethics hotlines can be risky and may lead to termination. If you’ve already done this, call us immediately.
- Your coworkers could be aware of the fraud – or complicit in it – and you should not talk to them about it.
- The first claim to be filed under the False Claims Act can proceed – if you’re not first, you’re at a serious disadvantage and may get nothing (another reason not to speak to your coworkers about it).
- A confidential discussion costs you a few minutes, but could save you time, stress, and money.
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