Medicare Fraud

Medicare Fraud

Medicare, coupled with Social Security, are programs available in the United States that were created to ensure senior citizens and retirees are taken care of throughout their golden years. What many people are surprised to learn, however, is that Medicare can also be a source of many fraudulent activities in the healthcare industry. Some healthcare workers have noticed and exposed these cases of Medicare fraud, which may ultimately lead to their termination as a form of retaliation. If you have exposed a company, fellow colleague, or employer for their fraudulent activities regarding Medicare, you may be eligible to seek monetary compensation in a qui tam or whistleblower lawsuit.

A long list of acts can constitute Medicare fraud, but according to the National Whistleblower Center, the most common types of Medicare fraud that occur include fraudulent billing, such as billing Medicare for:

  • Procedures or treatments that were not needed
  • Procedures that were never performed
  • Unnecessary medical exams
  • Tests that were never performed
  • Unnecessary equipment

Typically, these acts occur in medical settings and offices, such as a doctor’s office, nursing home, hospice care provider, hospital, or dentist’s office. Making these fraudulent claims for reimbursement enables them to get paid for services they never performed or treatments that were never given. They pretend that they charged patients for these services and that they treated patients for certain conditions, when in fact, it is all fictitious in an attempt to get paid. This is a serious crime, and anyone who is found guilty of Medicare fraud may be subject to various consequences, including the requirement to pay back what they fraudulently took from the government. In fact, they may be ordered to pay three times the dollar amount that they stole.

Anyone who is subjected to workplace harassment, is demoted, discriminated against, or fired as a result of exposing Medicare fraud is typically protected under Section 3730(h) of the False Claims Act. There are, however, some exceptions to this as some courts are currently divided on how far this protection extends, and who may be excluded. For instance, many states have similar laws in place that may offer other solutions for certain acts of whistleblowing.

The statute of limitations for pursuing an FCA retaliation lawsuit is not the same as filing a qui tam recovery case. Additionally, other protocols must be followed when filing a lawsuit under the False Claims Act. If you haven’t found a lawyer yet, try not to worry too much about these specific factors. Your lawyer will be able to tell you with certainty if you do have a case worth pursuing, and if so, he or she will likely be happy to represent you. Additionally, your lawyer will know exactly which type of case to pursue. If you are eligible for protection under the False Claims Act, you may be eligible to receive compensation for special damages, such as litigation expenses and certain legal fees. You may also qualify to receive double back pay, and you may also have the opportunity to be reinstated.

Did you expose someone else’s wrongdoing and reveal to authorities that they were committing Medicare fraud? Were you treated unfairly at work as a result, or worse, were you terminated as a result of your actions? If exposing Medicare fraud recently cost you your job, it’s likely that you are eligible to move forward with a qui tam or whistleblower lawsuit. If you are working with an attorney on your case, you may be counting on receiving that settlement money as soon as possible. After all, plaintiffs pursuing monetary damages in these types of lawsuits are typically no longer receiving regular paychecks due to being fired. As a result of losing their jobs, plaintiffs may be struggling to pay bills and expenses, leaving them in desperate financial situations.

Encouraging your attorney to wrap up the case as quickly as possible is often not advised, as your attorney is likely working at a pace that’s necessary to recover the largest award possible. Additionally, turning to debt and credit cards can be a costly mistake if you’re looking for a quick financial solution.

One of the best ways to receive money while waiting for a pending lawsuit to finalize is to take advantage of pre-settlement funding, which is also commonly referred to as a lawsuit advance. This is the ideal option for plaintiffs looking for a compromise when it comes to receiving money upfront versus trying to finalize their case as quickly as possible. It enables them to receive money sooner, while also giving their attorneys the time they need to fully resolve their lawsuits.

Are you ready to learn more about pre-settlement funding and how it can help you receive money sooner? Contact USClaims today to find out if your case is eligible, and how you can get the process started.

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