Fraud Against The Federal Medicare Program
What is Medicare?
The Medicare Program is a Federal program that provides healthcare coverage for 57 million Americans who are over the age of 65 or disabled. With more than $540 billion in annual expenditures, it is no wonder that Medicare Fraud continues to cost taxpayers tens of billions of dollars a year.
What is Medicare Fraud?
Medicare Fraud occurs when healthcare providers knowingly submit claims to Medicare that are inflated or not eligible for reimbursement. The Medicare program is separated into four different “Parts,” including Part A (hospital stays, skilled nursing and home health), Part B (physician services, outpatient drugs and laboratory testing); Part C or Medicare Advantage (managed care plan options), and Part D (prescription drug coverage). Fraud affecting any program or plan funded by these Parts can be considered Medicare Fraud.
What are some common Medicare Fraud schemes?
Some of the most commons forms of Medicare Fraud include:
- Double billing;
- Up-coding;
- Billing for services that were not provided or not medically necessary;
- Kickbacks schemes;
- Physician Self-Referral Law, also known as Stark Law, violations;
- Pharmaceutical marketing violations, including off-label marketing;
- Inflating patients’ risk scores for managed care plans;
- Improperly inflating drug pricing measures such as Average Sales Price;
- Hospice fraud;
- Improper inpatient admissions or prolonging Part A hospital stays;
- Unnecessary laboratory testing and physician kickbacks; and
- Fake clinical trial and research schemes.
How is Medicare Fraud Different than Medicaid Fraud?
Medicare is administered by the Federal Government, meaning False Claims Act cases for Medicare Fraud must be brought under the Federal False Claims Act. Many types of Healthcare Fraud cases involve both Medicare and Medicaid, meaning many cases are simultaneously brought under the Federal False Claims Act and each State’s False Claims Act.
What can I do to stop Medicare Fraud?
If you have knowledge and proof that a company or individual is submitting false claims in relation to Medicare Fraud, then give us a call today for a free consultation and case review with an experienced whistleblower attorney.
This information is for educational purposes. It is not offered as and does not constitute legal advice or legal opinions. You should not act or rely upon this information without seeking the advice of an attorney.
WHISTLEBLOWER NEWS
- 2017 False Claims Act Year in Review: Government Recovers $3.7 Billion
- Do You Work For A Motor Vehicle Manufacturer, Supplier, Or Dealership And Came Across Safety Violations Your Employer Is Trying To Keep Hidden? Don’t Let Them Get Away With It, Call Now!
- 2016 False Claims Act Year in Review: Whistleblowers Collect $519 Million
- New Study Confirms Importance of Whistleblowers in Preventing Corporate Fraud
- Where was the Wells Fargo Whistleblower? Part II.
- Fiscal Year 2016 Record Year for SEC Whistleblowers - $57 Million Awarded to Whistleblowers!
- SEC Investigating Wells Fargo Fraudulent Practices
- Whistleblower First! SEC Rewards Whistleblower $3.75 Million For Reporting Violations of the Foreign Corrupt Practices Act.
- Did Your Employer Actually Qualify For That Government Set-Aside It Received? Did Your Competition Win A Contract It Didn’t Deserve?
- Hiding Wealth Offshore To Avoid Paying Taxes Is Illegal And IRS Will Reward Those Who Blow The Whistle On Anyone That Tries
- Aware of Banks and Mortgage Lenders Defrauding the Government Through FHA or VA Insured Loans? Don’t “Short” The Market, Contact Us!
- U.S. Education Department Creates New Unit to Investigate Student Aid Fraud
- The False Claims Act Year in Review: Whistleblowers Collect a Record $597 Million
- False Claims Act Update: Top Recoveries & Enforcement Trends from 2014
- Whistleblower Attorneys Recover $1M in Medicare Fraud Case
- Qui Tam Attorney Discusses the DOE’s Final Gainful Employment Rules
- Career Education Corporation Agrees to $10.5 Million Settlement Over Inflated Employment Rates
- Pharmaceutical Company to Pay $40.1 M to Settle Whistleblower Lawsuit
- Qui Tam Lawsuit Involving Healthcare Fraud Intervened by US Government
- Medicare Fraud Responsible for $23 Million Paid to the Dead in 2011?

Find out whether you have a case by speaking to one of our experienced lawyers via our 24/7 toll-free hotline or by submitting an email inquiry. Our attorneys will be quick to respond to you and happy to answer all of your questions.


Know the Difference
Committed to Doing What's Right-
Over $3 Billion Won
We have represented numerous individuals and groups of workers, winning for them multi-million-dollar settlements and verdicts.
-
There's No Case Too Big
Our team has achieved groundbreaking victories in highly complex cases and has gone up against some of the toughest defendants in the country.
-
Trial Attorneys
Our attorneys excel in the courtroom and are not afraid to bring a case in front of a jury if a fair settlement for the client has not been reached.
-
A Thought Leader in the Industry
Our firm's knowledge and experience are in high demand, and many news outlets have asked us to share our legal expertise.
-
Access to World Class Resources
Our experienced attorneys use cutting-edge technology and highly regarded experts to help us achieve the best possible result for our clients.
-
Changing the World for Good
We not only want to achieve the best possible results for our clients, but we also strive to prevent future harm by changing public health policies.

Thousands of Clients Helped
Hear What They Have to Say
-
Professional, responsive and very good at their jobs.
“From the first visit to my home, to my last visit to the office to collect my settlement, I was very happy with the services provided by this firm. They are professional, very responsive and very good ...”
- Lisa Ross -
They have truly gone above and beyond.
“I have been beyond pleased how Levy Konigsberg is handling my matter. They answer my questions in a timely matter and when warranted, ease my worries and concerns. They have truly gone above and ...”
- Anne Fahey -
I put my Faith and Trust into Corey Stern!
“Selecting a Law firm to represent me was one of the biggest decisions I've had to make in my life. I put my Faith and Trust into Corey Stern, and he exceeded all my expectations.”
- Dennis McGowan -
With this team on my side we came out on top.
“Levy Konigsberg and team are a group of men and women that give their all, down to the receptionist. I had a case that was almost unbeatable but with this team on my side we came out on top. They keep ...”
- Angie Garrido -
Very happy with our settlement.
“My husband and I were VERY happy with our experience with this firm. They were always caring and really helped us go through this in a very hard time in our lives .We continue to be in touch with the ...”
- Lori Rosa -
Wow is all I can say.
“It has been a few years now but I needed to post this. My dad suffered so much from Mesothelioma. My brother looked into the law and our rights. Unfortunately he died also before anything was done. It ...”
- Carol N. -
Their dedication to receive the highest results for their clients was amazing.
“Working with Levy Koningsberg LLP was a very positive experience. Their professionalism and curiosity was outstanding. I was a pleasure working with this firm. Their dedication to receive the highest ...”
- Emily DeRogatis -
Such a great team!
“The whole team at Levy, Konigsberg LLP have been extremely professional and kind during our most difficult time. They keep you informed during the process, check in often asking if there are any ...”
- Kevin Kober -
We definitely got the right law firm!
“Levy Konigsberg represented my daughter Linda, who was diagnosed with mesothelioma at 16 years old. She endured many surgeries and chemotherapy including HIPEC. She traveled the country seeking ...”
- Mark Wells -
Levy Konigsberg continued to help my family fight for the justice my father deserves.
“Levy Konigsberg was there for my father as soon as he was diagnosed with mesothelioma they helped him get medical treatment in another state that specializes in his condition and even provided housing ...”
- Stephanie Vitale


Our Blog
-
Do You Work For A Motor Vehicle Manufacturer, Supplier, Or Dealership And Came Across Safety Violations Your Employer Is Trying To Keep Hidden? Don’t Let Them Get Away With It, Call Now!View Article
- Whistleblower / Qui Tam
-
2016 False Claims Act Year in Review: Whistleblowers Collect $519 MillionView Article
- Whistleblower / Qui Tam
-
New Study Confirms Importance of Whistleblowers in Preventing Corporate FraudView Article
- Whistleblower / Qui Tam