Fort Lauderdale Medicare Fraud Lawyer
Medicare exists to provide healthcare services for those who are 65 and older and those who are disabled. Medicare fraud can happen in numerous ways, including through medical professionals billing Medicare for services they did not provide. Both patients and employees in the healthcare industry are able to report Medicare fraud. A Fort Lauderdale Medicare fraud lawyer is crucial to help you take the right steps and protect your rights in the process.
Medicare fraud costs taxpayers and individuals who need the benefits of Medicare most of all. If you see signs that your employer or medical provider is engaging in this form of fraud, you should take action. You could even recover certain damages.
Helping Employees and Patients Navigate Healthcare Fraud Reports
Employees have unique risks when reporting Medicare fraud. While it is illegal for an employer to retaliate against you for whistleblowing in good faith, it can still happen. Working with a fraud attorney when reporting potential Medicare fraud can help you determine if you have a good-faith reason to suspect fraud and the most effective way to report it.
Call For A Free Telephone Consultation
Call (786) 446-7288 for a free telephone consultation with our office or use our contact form to tell us more about your situation.
At the Law Offices of Gary A. Costales, P.A., we can help you protect your rights and determine how to proceed with a claim, whether you are a patient or an employee. You may be able to file a False Claims Act complaint or another type of claim against the fraudulent medical provider. Our firm provides straightforward and dedicated legal representation. Our goal is to hold providers engaging in fraud accountable and help you protect your own financial interests.
When the claim you are filing is on behalf of the government, unique laws can apply. Our firm can explain the process to you and help you gather the information you need to file a complaint.
What Is Medicare Fraud?
Medicare fraud can occur when you, as a recipient of Medicare, have your number stolen by another party so they can use your benefits. Medicare fraud also occurs when healthcare providers engage in fraudulent actions to be paid by Medicare. This is also called Medicare billing fraud and can result in increased healthcare costs. There are several ways that medical providers can engage in Medicare billing fraud, including:
- Billing Medicare for procedures and services that the provider did not perform.
- Billing Medicare for medically unneeded services and procedures.
- Upcoding or billing Medicare for medical procedures that are more complicated and costly than the procedures that were performed.
- Unbundling, or billing procedures separately to require higher reimbursement from Medicare that the provider would have received for the procedures together.
- Using false or stolen certifications to bill Medicare.
- Making illegal referrals for specific healthcare services.
- Receiving or paying money to reward referrals for healthcare products.
- Misrepresenting the abilities and safety of a pharmaceutical drug or medical device.
There are many other potential abuses of Medicare in the healthcare industry across many different types of healthcare facilities. Companies and individuals who provide healthcare products can also engage in Medicare fraud.
Reporting Medicare Fraud
When Medicare billing fraud occurs, employees working for a healthcare provider or facility who suspect or learn of billing fraud can report it. If you are an employee who notices improper billing procedures, you can file a claim on behalf of the government under the False Claims Act. This claim can also allow you to recover a portion of the damages.
Many employees worry that reporting billing fraud will cause them to lose their jobs. When you blow the whistle on fraud at your workplace and the misuse of government resources, you cannot be fired for that. If you are, you can file a claim for illegal termination and recover damages for your employer’s illegal actions.
Patients can also report Medicare billing fraud. You may notice Medicare fraud due to charges for services not rendered or referrals where the provider making the referrals has a financial interest. You could also be receiving medical treatment that you don’t need. A skilled Medicare fraud attorney can help you review your situation and determine if you can pursue a case.
FAQs
The Office of Inspector General (OIG) and its Medicare Fraud Control Unit (MFCU) investigate Medicare fraud in the U.S., including Florida. The OIG and MFCU are part of the U.S. Department of Health and Human Services (HHS). The Federal Bureau of Investigation is also responsible for investigating healthcare fraud, both federal and private healthcare.
When healthcare companies and providers improperly bill Medicare and Medicaid programs, they are stealing money from these programs. These agencies investigate and prosecute offenders.
You can report Medicare fraud in Florida by reporting it to the HHS-OIG directly, by calling, mailing, faxing, or submitting a complaint online. The general public, patients, those who receive Medicare, and medical providers can all report Medicare fraud in Florida. If you are a medical provider or work in the industry, you have protections as a whistleblower and are protected from retaliation. An experienced employment attorney can help you navigate reporting fraud.
Yes, a Medicare fraud whistleblower can remain anonymous and not provide any identifying information when filing an online complaint. However, this will make it more difficult for the HHS-OIG to investigate the claims and prevent the agency from investigating it as a whistleblower complaint.
Another option is to request confidentiality as a whistleblower, meaning that only the HHS-OIG has access to identifying information unless disclosure is deemed necessary. This can still limit the resolution of the complaint, unfortunately.
A violation of the False Claims Act (FCA) in the medical industry occurs when a medical provider submits a bill to Medicare, and one of the following is true:
- It is for services they know they did not provide.
- The provider overbilled the patient.
- It was for an unnecessary procedure.
This means that Medicare pays the medical provider for false or upcoded services, stealing from the governmental program. Under the FCA, the provider is liable for this action.
Holding Providers Accountable
If you believe a medical provider or facility is engaged in Medicare billing fraud, contact the Law Offices of Gary A. Costales, P.A., today. We can help you review the evidence and your reporting options.
