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
I am the Victim of Fraud. What Should I Do?
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 Medicare/Medicaid Fraud?
Charges of Medicare / Medicaid fraud are very serious and carry substantial penalties. A personal injury attorney can inform you of your rights and possible defenses, as well as properly guiding you through the complex legal system.