“Overcharging” refers to certain types of healthcare fraud wherein a healthcare provided knowingly charges customers erroneously in order to reap profits. Overcharging is a serious offense and can result in millions of losses of dollars in the health care industry each year. Sometimes, these can be small overcharges that are applied to hundreds or thousands of clients and patients; however, if this is multiplied across several healthcare organizations across many states, it can create devastating losses for the industry.
Some common forms of overcharging include:
- Charging too much for a service (based on industry rates)
- Charging for services that were never performed
- Double or triple charging
- Charging for the use or purchase of medical equipment, treatments, or medicines that are not actually needed
- Overcharges related to off-label practices (prescribing medicines for purposes other than what they were intended for) or inaccurate drug labels
- Billing for brand name products even when generic products were issued
- Switching prescription drugs, or billing for non-existent prescriptions
Overcharging can take many different forms. The overcharge may only be for very small amounts—the harm occurs if the overcharging is spread across many customers.
Who Can be Held Liable for Overcharging Claims?
Overcharging rings or schemes sometimes involve many different persons or parties. In fact, they typically require the involvement of many different persons working in concert to knowingly accomplish the overcharging scheme. Liable parties may include:
- Doctors and physicians
- Nurses and other hospital staff
- Hospital management and administration
- Insurance agents and adjusters
- Tax agents and accountants
- Manufacturers of drugs and medical products
Sometimes, investigations into overcharging rings can uncover massive fraud and illegal activity. Investigations often rely on a whistleblower to alert authorities to the fraud.
Are There any Legal Remedies for Overcharging Cases?
Overcharging can lead to massive losses spread across many consumers. For this reason, overcharging lawsuits are frequently filed as class action suits. These typically result in a monetary damages award to compensate the plaintiffs for their losses. Part of the danger of overcharging claims in the healthcare industry is the risk of injury (for instance, with improper prescriptions). Separate damages may be filed to address these types of injuries as well.
In many cases, overcharging rings may also result in criminal investigations. These can lead to criminal charges and consequences as well for the affected defendants.
Do I Need a Lawyer for Help with an Overcharging Lawsuit?
Overcharging lawsuits can be very complex filings, often involving multiple parties and large amounts of damages. It may be in your best interests to hire a personal injury lawyer in your area for assistance with a claim. Your lawyer can provide you with legal research, information, and guidance for your case. Also, if you need to make an appearance in court, your attorney can provide you with the necessary legal representation at those times as well.