Understanding Healthcare Fraud, And How You Can Stop It

The United States government spends hundreds of billions of dollars every year on healthcare programs. This includes Medicaid, Medicare, healthcare for veterans, and a host of others. Whatever the funding program, it is often non-governmental healthcare agencies, contractors, and businesses that provide the actual care. 

Generally, these non-governmental entities provide appropriate medical services to qualified patients and then charge the government for said services. At least, that’s the way it’s supposed to work. 

Unfortunately, sometimes agencies, contractors, or businesses will charge the government without properly providing services. This is called healthcare fraud, and it can happen in a variety of ways (click here for a list of some of the most common ones). 

Overcharging, providing services with less-qualified personnel, “treating” phantom patients — the list is endless. But all of these situations result in the federal government paying for a service or product that it neither intended nor agreed to pay for. 

Whether the crime is being committed by one rogue employee or as a directive from the very top, healthcare fraud is wrong. Fraud committers are stealing money that was meant to pay for necessary healthcare, often dedicated to vulnerable populations — the theft isn’t just illegal, it is morally repugnant. 

If you are an employee of an agency, contractor, or business that charges the government for medical services and have seen or are aware of fraud, there’s something you can do about it. 

Speak Up, Safely

It can be hard to come forward and accuse your employer or co-worker of fraud for a number of reasons. You may fear retaliation, losing your job, or being forced to work in a hostile environment. But that’s not how it has to play out. 

Under the False Claims Act, whistleblowers who report fraud against the federal government are legally protected from retaliation by their employer. If they are retaliated against, they have the right to sue, and potentially receive compensation. 

Coming forward can be financially rewarding, too. Under federal law, whistleblowers whose complaint leads to the federal government’s financial recovery are entitled to a percentage of that money. 

In May of 2020, the U.S. Securities and Exchange Commission (SEC) awarded almost $50 million to a whistleblower who helped the government recover defrauded money. 

The Importance Of Hiring The Right Attorney 

It’s always a good idea to get a good lawyer, but with whistleblower cases, it’s even more crucial. Blowing the whistle does often mean putting yourself at risk. A qualified whistleblower attorney can help minimize that risk, and maximize your chances of being rewarded. 

From the very beginning, discretion is key, along with carefully following all laws and procedures. Especially in the healthcare field, there are many intersecting laws and regulations that can have an effect on the eventual outcome of a whistleblower case. That’s why it’s so important to have someone on your side who knows the landscape and how to protect you from the very start. 

Morgan & Morgan’s whistleblower team is staffed by qualified, experienced attorneys and case managers who have been helping whistleblowers safely come forward for years. We also have a team of former FBI agents onboard who help us navigate the federal legal landscape on behalf of our clients. 

If you have witnessed or been made aware of federal healthcare fraud in your workplace, give us a call for a completely free, confidential consultation. Your privacy will be safeguarded, and you will be advised on your options. 

If we take your case, you won’t have to pay a penny upfront, and won’t have to pay anything at all unless we successfully resolve your case. Morgan & Morgan has recovered more than $7 billion for our clients to date, and we want to help you pursue justice and compensation too. 

Call today. We want to help you put a stop to healthcare fraud.