The government funds the largest three healthcare programs. These are Medicare, Medicaid, and Tricare. Healthcare consumes approximately 40% of federal spending, with Medicare spending approximately $350 billion, and Medicaid totaling approximately $320 billion.
The majority of healthcare providers and suppliers bill only for services performed. However, many cheat these programs. This equals billions of dollars annually. There were 62 healthcare qui tam cases recorded from 1987 to 1992. In 2011 alone, there were 417. Another 412 were recorded in 2012, according to a study by Taxpayers Against Fraud.
Medicare and Medicaid lose an estimated $60 billion or more annually to fraud. Since 1990, the Government Accountability Office labeled Medicare a high-risk program. Whistleblowers shine a light on ways providers defraud the government. This rate of qui tam cases is not expected to slow down, especially since whistleblowers may have even more incentive to bring charges.
In April 2013, Centers for Medicare and Medicaid Services (CMS) proposed a rule that would increase the incentive program for whistleblowers who provide information that leads to the recovery of improper Medicare payments. The rule would expand how much CMS can reward whistleblowers under its Medicare Incentive Reward Program, which is separate from the FCA.
Common Types of Healthcare Fraud
There are many different types of healthcare fraud. They vary depending on the healthcare program.
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Therefore, if you believe you have uncovered evidence of fraud involving a government-funded program, contact us today. Our attorneys have represented many clients in the past with complex cases. We will work tirelessly to obtain results on your behalf.