What is Medicare/Medicaid Fraud?
Medicare and Medicaid are government programs that provide healthcare. Medicare/Medicaid fraud includes: - Billing for Services not Performed ¿ For example, billing for an x-ray never taken
- Substitution of Generic Drugs ¿ A pharmacy substituting a generic drug for a brand name drug at a substantially lower cost, but then billing an insurance carrier or patient for the brand name drug
- Unbundling ¿ When a provider takes one medical procedure and breaks it down to bill each of its component parts ¿ an example would be a provider billing for a surgery, and then billing again for a check-up appointment for the patient the following week
- Unnecessary Services ¿ Provider falsifies patient¿s diagnosis to get payment for unnecessary lab tests
- Double Billing ¿ A provider bills both Medicaid and the insurance carrier or patient for the same services
What Should I Do if I Have Been the Victim of Medicare/Medicaid Fraud?
Recovering your losses from the fraud can be complicated and difficult. A health law attorney can advise you of what steps to take to report the fraud and what remedies you are entitled to. If need be, a health law lawyer can also represent you in court. What Should I Do if I Have Been Accused of Participating in Medicare/Medicaid Fraud?
Charges of Medicare/Medicaid fraud are very serious and carry substantial penalties. A health law attorney can inform you of your rights and possible defenses, as well as properly guiding you through the complex legal system. |
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