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Medicare Fraud Whistleblower Attorneys

Brewer & Pritchard Delivers Results for Clients Who Need Knowledgeable Representation

Medicare fraud is a serious problem that requires a sustained commitment to fight those who fraudulently bill Medicare, companies that pay kickbacks to doctors in exchange for referrals and who engage in other schemes that harm taxpayers and the elderly alike.

At Brewer & Pritchard, our Medicare fraud whistleblower attorneys know that professionals who step forward and shed light on those who commit healthcare fraud and abuse are extremely critical in stopping the problem. We accept cases throughout the United States. Contact us today.

What is Medicare?

The federal health insurance program called Medicare provides coverage for people who are 65 or older and for certain disabled people. Payroll taxes and premiums paid by the individuals who receive benefits (beneficiaries) fund the program.

Why are whistleblowers necessary?

Because Medicare is such a huge program, oversight can be lax. The government often pays claims without any extensive investigation. This creates an opportunity for dishonest people to commit fraud and abuse, which in turns costs taxpayers billions of dollars.  That's why the government relies heavily on whistleblowers, who are entitled to compensation for their role in qui tam lawsuits. These "relators," or the whistleblowers whose names are on lawsuits, often receive 15 percent to 30 percent of the recovery. This could mean millions of dollars for a whistleblower who uncovers substantial fraud.

What are the types of Medicare Fraud?

The following types of action involving Medicare may be grounds to file a whistleblower lawsuit:

  • Billing Medicare for medically unnecessary services or goods
  • Billing Medicare in a way that does not accurately reflect the goods or services rendered (see our page about upcoding)
  • Billing Medicare for several parts of a single procedure (see our page about unbundling)
  • Billing Medicare for brand-name drugs when generics are provided
  • Falsifying a patient's diagnosis to justify surgeries, treatment, or drug prescriptions
  • Charging for a doctor's rate when a nurse or assistant performed the task
  • Medicare identity theft (misusing a person's medical identity to wrongfully obtain healthcare goods, services or funds)
  • Offering kickbacks to patients (such as asking homeless or drug-addicted people to participate in mock procedures or signing their name on fraudulent bills)

Kickback schemes involving Medicare

Healthcare providers also sometimes unscrupulously pay kickbacks in return for referring patients covered by Medicare or Medicaid, a state and federal healthcare program. Pharmaceutical companies might offer generous incentives to doctors and clinics in exchange for pushing their drugs. Sometimes, these kickback schemes result in doctors writing prescriptions for drugs that don't help the patients. It's not only a waste of taxpayer money, but the patient may suffer dangerous side effects from taking the unnecessary drugs.

The federal Anti-Kickback Statute prohibits the exchange of anything of value to reward the referral of federal health care program business. A conviction can result in a fine of up to $25,000 and up to 5 years imprisonment.

To reach Brewer & Pritchard, call 1-800-445-8710 and find out how we can help you.