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Financial rewards available for reporting Medicare Fraud
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Medicare & Insurance
Financial rewards available for reporting Medicare Fraud
Share Medicare dos and don’ts, including eligibility and supplemental insurance.
Has a doctor, other health care provider, or medical equipment provider, pressured you into receiving services or medical products that you do not need?  Have you been offered cash or gifts to re
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Cat:91a4afbf-9555-4e02-b9d3-9eef604476f6Forum:c79f53c3-fa71-4e76-b517-aef042efd7ff
Cat:91a4afbf-9555-4e02-b9d3-9eef604476f6Forum:c79f53c3-fa71-4e76-b517-aef042efd7ffDiscussion:a70fc332-e3f4-4868-9e42-f3292e365915

Forums » Health » Medicare & Insurance » Financial rewards available for reporting Medicare Fraud

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Forums  »  Health  »  Medicare & Insurance  »  Financial rewards available for reporting Medicare Fraud

Financial rewards available for reporting Medicare Fraud

posted at December 18, 2012 2:23 PM EST
Posts: 4
First: December 18, 2012
Last: December 19, 2012
Has a doctor, other health care provider, or medical equipment provider, pressured you into receiving services or medical products that you do not need?  Have you been offered cash or gifts to receive medical services or equipment?

Under  false claims laws, whistleblowers can receive substantial rewards for exposing medicare  fraud.

Fraudulent practices include:
-- billing for services not performed, or for medical equipment that is not provided
-- billing for services or equipment that are not necessary
-- "upcoding," or billing for a good or service that is more expensive than the one actually provided
-- paying kickbacks to referring doctors, or to patients

If you are aware of any fraudulent billing practices contact us immediately.

Matt Miller
mmiller@cuneolaw.com
Cuneo, Gilbert & LaDuca, LLP
507 C Street NE
Washington, DC 20002
(202) 587-5067

Re: Financial rewards available for reporting Medicare Fraud

posted at December 18, 2012 10:34 PM EST
Posts: 1923
First: November 27, 2011
Last: May 18, 2013
Why report it to a law firm when we can report it to Medicare directly?

MEDICARE:  Report fraud & abuse

And I think that is pretty sleezy mentioning a financial reward.
How much does the government (HHS) pay for your services?
Are you contracted with the DOJ?

Explain your involvement and how your services are needed or The AARP should remove your post.
 

Re: Financial rewards available for reporting Medicare Fraud

posted at December 19, 2012 10:13 AM EST
Posts: 4
First: December 18, 2012
Last: December 19, 2012
In Response to Re: Financial rewards available for reporting Medicare Fraud:
Why report it to a law firm when we can report it to Medicare directly? MEDICARE:  Report fraud & abuse And I think that is pretty sleezy mentioning a financial reward. How much does the government (HHS) pay for your services? Are you contracted with the DOJ? Explain your involvement and how your services are needed or The AARP should remove your post.  
Posted by GailL1


I don't believe that it is sleazy (not "sleezy") at all to mention a financial reward.  The federal False Claims Act (the "FCA") was enacted in 1863, and provides that persons bringing suit for the benefit of the federal government, if successful, are entitled to a percentage of the government's recovery.  Fraud is sleazy.  Exposing seniors (and others) to unnecessary medical tests and dangerous and unnecessary surgeries is sleazy.  Litigation under the False Claims Act is a remedy against fraud and sleaze. 

No, we are not paid by DOJ or the federal government.  Lawyers who represent "relators" (persons who bring claims under the FCA), like their clients, receive some percentage of the proceeds if they are successful.  They do not collect anything from anyone if they are not successful in helping the government recover from the persons committing fraud.

What exactly is "sleazy" about that?

Re: Financial rewards available for reporting Medicare Fraud

posted at December 19, 2012 11:45 AM EST
Posts: 1923
First: November 27, 2011
Last: May 18, 2013
In Response to Re: Financial rewards available for reporting Medicare Fraud:
In Response to Re: Financial rewards available for reporting Medicare Fraud : I don't believe that it is sleazy (not "sleezy") at all to mention a financial reward.  The federal False Claims Act (the "FCA") was enacted in 1863, and provides that persons bringing suit for the benefit of the federal government, if successful, are entitled to a percentage of the government's recovery.  Fraud is sleazy.  Exposing seniors (and others) to unnecessary medical tests and dangerous and unnecessary surgeries is sleazy.  Litigation under the False Claims Act is a remedy against fraud and sleaze.  No, we are not paid by DOJ or the federal government.  Lawyers who represent "relators" (persons who bring claims under the FCA), like their clients, receive some percentage of the proceeds if they are successful.  They do not collect anything from anyone if they are not successful in helping the government recover from the persons committing fraud. What exactly is "sleazy" about that?
Posted by MattMiller


Sorry about my misspelling - I'll blame it on being old with fingers that don't work like they use to

Why report it to a law firm when we can report it to Medicare directly - if the alleged medical servicer is practicing actual fraud, then the DOJ should take care of them.

Why should the government pay us for performing a service to our country? 

Your explanation of what might be wrong or improper isn't something that most providers or servicers do but could be interpreted incorrectly by some doing the reporting.   So before reporting for financial rewards becomes a fad, people should understand exactly what constitutes a fraud in this case.  I think those paying the bills are the best source of research into this matter -  in this case government.

Stick to medical malpractice and let HHS, DOJ, Medicare, CMS listen to the complaints of seniors on thing they think is wrong.  Let them be the initiator as to when charges are filed  when a medical servicer is actually performing as a criminal. 

Your services & the financial rewards in this area, to me, would seem to add to our already high cost of Medicare or even Medicaid.

We have a PPACA to get up and running with expanded Medicaid if it all stays intact - we have enough worries now about having enough providers - so we don't need any false claims made nor do we want to take up their time and money fighting unsubstantiated claims.

Government has all the records and the various departments for any investigation - the goal is to shut them down, fine them, throw them in jail . . . . whatever is the case.  Citizens should do their duty if they find or experience something that is not quite right - reporting it as Medicare has asked - as all good citizens should.

Re: Financial rewards available for reporting Medicare Fraud

posted at December 19, 2012 12:38 PM EST
Posts: 4
First: December 18, 2012
Last: December 19, 2012
Going directly to the government is an alternative means of responding to fraud.  If you are not interested in financial incentives to bring actions against wrongdoers, that's fine, but others might be.

False claims litigation does NOT increase the cost of Medicare.  To the contrary, it is a very effective means of fighting fraud.    Do you think we should get rid of the FCA and replace it with an "800" number at Medicare?  The fraudsters would love that.  There is a reason the FCA exists, and FCA claims are welcomed by DOJ.  Many of the biggest Medicare frauds have been brought to light by FCA claimants, rather than by the government itself.

Also note that, when a claim is brought under the FCA, the DOJ has the option to take over the case.  If the DOJ takes the case, the relator receives a somewhat lower percentage of the recovery (15-25% rather than 25-30%).  Thus, the the case will be litigated by the relator only of DOJ declines.  And the 15-25% the relator receives if DOJ takes the case, in my opinion, is a very reasonable price to pay to someone who has gone out on a limb to investigate and bring suit.

Forums » Health » Medicare & Insurance » Financial rewards available for reporting Medicare Fraud