Healthcare Fraud

Fraud Against Medicare, Medicaid, and Other Government Healthcare Programs

What is Healthcare Fraud?

Fraud against the Government healthcare programs, including Medicare, Medicaid, and TRICARE, continues to account for the majority of False Claims Act recoveries and whistleblower rewards. In 2015, the Department of Justice recovered $1.9 billion from companies and individuals in the healthcare industry who were alleged to have defrauded the Federal healthcare programs.

These recoveries resulted in more than $330 million in rewards to whistleblowers who reported the fraud by filing a False Claims Act whistleblower or qui tam lawsuit. Healthcare spending accounts for more than $600 billion a year in Government spending and it is no surprise that whistleblowers play a vital role in helping the Government identify and stop Healthcare Fraud.

What are some types of Healthcare Fraud?

There are many different types of Healthcare Fraud that may fall under the False Claims Act. This includes:

  • Charging Medicare, Medicaid, or TRICARE for services not provided or medically unnecessary;
  • Up-coding or double billing;
  • Engaging in Pharmaceutical Fraud by marketing drugs or medical devices for uses that have not been approved by the FDA; and
  • Improper payments to physicians or other referral sources, also known as kickbacks, in violation of the Stark Law or the Anti-Kickback Statute.

Where can I learn more?

For more information on these specific types of Healthcare Fraud, please review our in-depth pages to learn about common violations under the False Claims Act:

What can I do to stop Healthcare Fraud?

If you have knowledge and proof that a company or individual is submitting false claims in relation to Healthcare 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.

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