Medicaid fraud costs taxpayers billions each year and whistleblowers are critical in recovering that money.
A majority of states and the federal government have enacted False Claims Acts. These laws recover taxpayer money lost to fraud by employers and medical providers, and can result in significant damages awards from hospitals, doctors, pharmacies, home health care groups and healthcare providers caught in billing scams, kickback arrangements, or other schemes.
These laws have whistleblower provisions that can result in significant cash rewards of 15 to 30 percent of the money recovered by the government, as long as the tipster is:
- The first to report the fraud with,
- Non-public information that,
- Helps make a Medicaid or Medicare fraud case.
All False Claims Acts also protect tipsters who blow the whistle with anti-retaliation rules making it illegal to fire or harass an employee who reports fraud.
See Something? Say Something.
You May be Entitled to a Large Cash Reward
if You Have Information on the Following Types of Fraud
- False Documentation – Altering reports or cost claims, falsifying medical records, incomplete record maintenance, billing scams
- Homecare or Hospice Fraud – Billing Medicaid for higher level of care than provided, services not provided, no physician certification, falsifying records, fake eligibility schemes, inadequate services
- Stark Law Violations – Referring patients to a medical provider in which you have an ownership interest
- Anti-Kickback Violations – Medical providers offering financial or other incentives in return for medical referrals of patients
- Pharmacy & Pharmaceutical Fraud – Billing for pharma or medical products without proper prescription, altering or forging documents, nurse completed prescriptions
- Ambulance & EMS Scams – Illegal deals between hospitals and ambulance companies, billing for supplies or services not provided, billing for higher services levels, unnecessary transport
- Medical Necessity Fraud – Billing for medically unnecessary product or services not medically necessary
- Billing Schemes - Medical providers billing Medicaid for products or services not provided, upcoding, unbundling, double billing, submitting claims for ineligible patients
Medicaid Fraud Education Center
Warning to Tipsters:
Important: Whistleblowers must follow a specific process to be eligible for a False Claims Act or other whistleblower cash award. Some have received millions, others (who failed to follow the precise process) received nothing.
To learn the process, read our 10 Step Whistleblower Guide to Reporting Medicaid Fraud.
Questions? Click below to learn about each of the following:
What is Fraud?
Medical provider billing scams, physician kickbacks & falsifying records are Medicaid fraud More
Tipsters who are first to report can earn large cash rewards for reporting Medicaid fraud More
31 States' False Claims Acts protects whistleblowers with big anti-retaliation penalties More
What Does Medicaid Fraud Cost Taxpayers?
Medicaid Whistleblower Rewards