Medicare fraud bilks taxpayers out of an estimated $60 billion a year reports the New York Times, Pervasive Medicare Fraud Proves Hard To Stop. $60 billion is approximately 10% of Medicare's annual budget. The Obama administration devotes approximately $600 million to combatting fraud and last year recovered some $4.3 billion in monies previously paid due to Medicare fraud, which is a not too bad 7-to-1 yield.
The means of Medicare fraud, as this blog has reported previously, are various and include the following:
- paying doctors illegal kickbacks to order unnecessary tests which needlessly inflates Medicare bills and payments, Whistleblower Medicare Fraud Suits Settled for $98 Million, Medicare Fraud - Whistleblower Suit Settled for $24 Million;
- upcoding, Medicare Fraud - Upcoding Alleged in Whistleblower Suit;
- prolonging chemotherapy infusion treatments by diluting the infusions and by billing for office visits as chemotherapy treatments, E'Town Clinic To Pay $3.7 Million to Settle Medicare & Medicaid Fraud Whistleblower Case;
- overcharging for medical devices by upcoding, Medicare & Medicaid fraud: Overcharging for Medical Device;
- performing unnecessary heart catheterizations or bypass surgeries, installing unnecessary stents and pacemakers, Medicare & Medicaid Fraud - Unnecessary Heart Procedures;
- billing for tests and procedures performed by unqualified or uncertified personnel, Medicare Fraud - Billing for Tests by Unqualified Personnel;
- overbilling and performing unnecessary tests, Medicare & Medicaid Fraud - Overbilling & Unnecessary Tests.
One way to combat both Medicare fraud and Medicaid fraud is by whistleblower suits brought under the federal False Claims Act. This law allows private citizens to file suit against companies and health-care providers that defraud the Medicare and/or Medicaid programs by the type of practices involved in these cases mentioned above. As an incentive for the whistleblowers and their attorneys, the False Claims Act permits the whistleblower to retain 15-25% of the monies recovered.
Lexington, Kentucky Medicare fraud and whistleblower lawyer Robert Abell represents whistleblowers in Medicare and Medicaid fraud cases; contact him at 859-254-7076.