Medicare and Medicaid kickbacks cost U.S. taxpayers hundreds of millions of dollars.
We can help you try to hold those engaging in kickback fraud accountable – and possibly get a reward for your effort.
Medicare and Medicaid Kickback Fraud in North and South Carolina
Healthcare fraud costs taxpayers money and compromises the credibility of government healthcare programs, with Medicare and Medicaid kickback schemes proving to be a common culprit.
The U.S. Department of Justice annually reports billions of dollars recovered from whistleblower cases in settlements from a variety of healthcare schemes, including kickbacks and billing fraud.
But brave whistleblowers like you can hold fraudsters accountable.
If you’ve witnessed suspicious activities involving Medicare or Medicaid kickbacks, you may be able to help stop it. Federal and state laws protect whistleblowers who come forward and whistleblowers can receive a significant reward in a successful case.
This guide will help you understand common types of Medicaid and Medicare kickback fraud, your rights under the law, and how to report suspected violations. If you suspect kickback fraud, call 1-888-292-8852 or contact us online now for a free, confidential conversation.
Common types of Medicare and Medicaid kickback fraud
Whistleblowers expose many different types of fraudulent kickback schemes that drain hundreds of millions of dollars from Medicare and Medicaid programs, including:
Remuneration for Referrals
Remuneration for ReferralsThis type of fraud involves healthcare providers receiving payment or other benefits for referring patients to specific services or facilities covered by Medicaid and Medicare.
Common examples of remuneration for referrals include:
- Cash, rebates, discounts, gifts, and free vacations and meals
- Free or subsidized employees/administrative support
- Free services or equipment
- Free or under market-price rent
- Above market-price payments for services provided or unnecessary services
- Payments for services not provided
- Inflated speaking fees to physicians
Waivers of Co-pays, Co-insurance, and Deductibles
Waivers of Co-pays, Co-insurance, and DeductiblesWhen healthcare providers routinely waive patient co-payments, co-insurance, or deductibles to attract more patients or increase profits, this results in false claims to Medicare and Medicaid.
Common examples of waivers of co-pays, co-insurance, and deductibles include:
- A physician practice consistently waiving the 20% Medicare co-insurance without assessing financial need or attempting to collect
- A hospital routinely writing off patient co-pays, co-insurance, or deductibles for certain profitable procedures
- A pharmacy waiving co-pays for specific medications
Free Goods and Services
Free Goods and ServicesThis scheme involves offering free items or services to induce referrals.
Common examples of free goods and services include:
- A medical device company providing free office equipment to physicians who use their products
- A home health agency offering “free” nursing staff to assisted living facilities in exchange for patient referrals
- A pharmaceutical company providing free gifts, meals, or travel to doctors for promoting their drugs
Pharmaceutical Kickbacks
Pharmaceutical KickbacksThis occurs when pharmaceutical companies offer compensation to encourage healthcare providers to prescribe their medications.
Common examples of pharmaceutical kickbacks include:
- A drug manufacturer paying “consulting fees” to doctors who frequently prescribe their medications
- Pharmaceutical reps providing trips disguised as “educational” events
- A pharma company using patient assistance foundations as a conduit for co-pay coverage to boost prescriptions
Contact our experienced attorneys at Carolina Whistleblower Attorneys if you have information about kickback fraud to discuss the best path forward for you.
How the Anti-Kickback Statute applies to Medicare and Medicaid kickback fraud
Federal law takes a firm stance against kickbacks in healthcare through the Anti-Kickback Statute (AKS), a criminal law that safeguards Medicare and Medicaid programs from fraud. Generally, the AKS prohibits knowingly offering or accepting anything of value to generate healthcare business involving government healthcare programs. Violation of the AKS is a felony.
The statute applies to both parties involved – those who pay kickbacks and those who receive them. Therefore, whether it’s a healthcare provider accepting payments for referrals or a company offering incentives to secure business, both actions violate federal law.
The Anti-Kickback Statute works in conjunction with the False Claims Act. If you are aware of a violation of the AKS, you cannot independently bring a claim against the alleged healthcare fraudster, but you can work with an attorney to file an FCA claim on behalf of the government based on that alleged violation of the AKS.
Reporting suspected Medicare/Medicaid kickback fraud
You can report Medicare or Medicaid kickback fraud by working with an attorney to file a lawsuit on behalf of the government under the False Claims Act.
An experienced whistleblower attorney can help you build a strong case while helping safeguard your best interests, protect you from retaliation, and helping you seek a maximum reward in a successful case.
Our experienced attorneys understand the complexities of Medicare and Medicaid fraud cases and know how to guide you through the whistleblowing process. We created our You-First Policy to protect our clients and offer confidence and peace of mind for those interested in coming forward and doing the right thing.
Contact us today at 1-888-292-8852 or contact us online for a free, confidential consultation to discuss your concerns about suspected Medicare or Medicaid kickback fraud.
Confidentiality for whistleblowers reporting Medicare/Medicaid kickback fraud
When reporting Medicare or Medicaid kickback fraud, protecting your identity remains a primary concern. What you talk about with your whistleblower attorney is completely confidential.
In addition, the federal False Claims Act (FCA) allow cases to be filed “under seal” which means that the defendant will not be notified of the claim for a specified time period. The FCA ensures that the complaint is under seal for at least 60 days.
Whistleblower protections against retaliation for reports of Medicaid/ Medicare kickback fraud
Under the False Claims Act (FCA), your employer is prohibited from punishing you in the following ways (and more) for blowing the whistle on Medicare or Medicaid kickback fraud:
- Discrimination
- Harassment
- Firing
- Demotion
- Suspension
- Involuntary relocation
- Making your work environment inhospitable
- Blackballing you from the industry
Our experienced whistleblower lawyers can help you understand all of the anti-retaliation provisions of the FCA and can fight back aggressively on your behalf against any retaliation.
Financial rewards for reporting Medicare and Medicaid kickback fraud
Whistleblowers can potentially receive a significant financial reward for reporting Medicare or Medicaid kickback fraud via a False Claims Act lawsuit. If the lawsuit is successful, you may be entitled to a portion of the government’s recovery – up to 30%, which can be millions of dollars.
There are specific requirements that must be met in order to collect a reward, and an experienced whistleblower lawyer can help you retain your eligibility for a reward throughout the process and fight for the maximum possible reward on your behalf in a successful case.
Contact an experienced whistleblower lawyer and help stop Medicare and Medicaid kickback fraud
Successfully blowing the whistle under the False Claims Act on Medicare or Medicaid kickback fraud requires careful preparation and precise legal guidance. As highly experienced whistleblower attorneys, we understand the complexities of these cases and the courage it takes to come forward.
Our team at Carolina Whistleblower Attorneys has successfully handled many whistleblower cases and has extensive experience fighting Medicare and Medicaid fraud.1,4 We work on a contingency fee basis, meaning there are no upfront costs and we only get paid if your case succeeds.2
When you partner with us, we will:
- Coordinate with government attorneys and follow the strict government protocol
- Work efficiently so that your claim can be filed as early as possible in the process – the first person to file a complaint is in the best position to receive a potential reward
- Guide you on the pros and cons of filing an FCA claim
- Build your case and help you try to secure key proof
- Help protect you from employer retaliation
- Ensure you retain your eligibility for a reward throughout the process
- Fight for the maximum possible reward on your behalf in a successful case
Ready to take action? Our experienced attorneys are ready to listen to your concerns, explain your rights, and help you determine the best path forward. Together, we can help stop Medicare and Medicaid kickback fraud while protecting your interests under the law.
Call 1-888-292-8852 or contact us online today for a free, confidential consultation.
FAQs
Will my identity be protected if I report Medicare or Medicaid fraud?
Yes, if your attorney files a whistleblower claim under the False Claims Act, that complaint will be “under seal” for at least 60 days. During this time, your identity is confidential and is not publicly disclosed.
Are there rewards for reporting Medicare and Medicaid fraud?
Yes, whistleblowers who file a successful False Claims Act lawsuit on behalf of the government can potentially receive a reward of up to 30% of the total amount recovered.