Healthcare Fraud Lawyers
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Find Out How To Receive Part Of The Recovery
Our Raleigh healthcare fraud lawyers are here to help you blow the whistle on Medicaid, Medicare, and pharmaceutical fraud and illegal kickbacks.
You Can Blow The Whistle And Stop The Fraud
The cost of healthcare in this country is truly astounding, and fraud contributes to those costs. The largest healthcare payers — the Medicare and Medicaid programs — are operated by the federal government. Consequently, the federal government is a major target for healthcare fraud. According to a Department of Justice report, whistleblowers have helped the government recover billions of dollars from fraudsters in since 2017. That number only continues to rise. This staggering figure serves as a testament to the good done by brave whistleblowers who put their careers on the line to report fraudulent and illegal conduct at hospitals, clinics, skilled nursing facilities, and other healthcare centers.
If you have knowledge of fraudulent activities at a healthcare provider, you have the power to take action and make a difference. Please, reach out to a our healthcare fraud layers in Raleigh to discuss your case with a lawyer who understands whistleblower laws. By reporting fraud, you can help safeguard public resources, promote integrity and accountability in the healthcare industry, and ensure that care is available to those who need it.
Medicaid & Medicare Fraud
Types Of False Claims
Our lawyers in North Carolina see many types of healthcare fraud, from improper billing to illegal referrals. It takes courage and intimate knowledge of healthcare billing and funding for whistleblowers to recognize and expose schemes against government programs. If you’ve uncovered any of the illegal activities mentioned below in your workplace, contact a healthcare fraud lawyer in Raleigh to determine your next steps.
Medicaid & Medicare Fraud
Healthcare fraud most often takes the form of improper billing for care provided under Medicaid, Medicare, or other government-paid healthcare programs, such as Tricare or Veterans Administration.
These are the most common types of improper billing:
Kickbacks and Referrals for Services, Products, and Physicians
Referrals are a routine part of the healthcare system. Your primary care doctor may refer you to a specialist for assessment or to a therapeutic provider for a specific treatment. However, when they are not handled correctly, referrals can generate fraudulent income for a healthcare provider.
One way providers may violate the law is by accepting kickbacks in return for referrals. Congress was concerned that kickbacks could affect patient care by distorting physicians’ decision-making involving referrals and treatment. As a result, federal law states that any claim resulting from a kickback may be prosecuted under the False Claims Act. The Anti-Kickback Statute prohibits the exchange of any form of payment or remuneration in return for referring a service or a product. In other words, healthcare providers cannot receive kickbacks or incentives for recommending specific treatments, medications, or medical devices. These laws aim to ensure that healthcare decisions are made in the best interest of patients, free from any improper financial influence or conflicts of interest.
The Stark Law prohibits a related phenomenon: self-referrals. A self-referral occurs when your doctor has a financial interest in the facility or provider he refers you to. Under the Stark Law, physicians may not refer Medicare or Medicaid patients to providers with whom they have a financial interest or close relationship, such as an immediate family member. This measure ensures transparency, integrity, and fairness in the healthcare system, safeguarding the interests of patients and promoting ethical medical practices.
Pharmaceutical Fraud
Common Forms Of Medical Fraud
Pharmaceuticals have saved millions of lives. Because of pharmaceutical innovations, many diseases and conditions that were once deadly are now manageable. As a result, the pharmaceutical industry is one of the wealthiest sectors in the U.S. economy. Annual sales continually exceed a trillion dollars.
Pharmaceutical companies are also responsible for some of the largest whistleblower recoveries in the history of the False Claim Act. GlaxoSmithKline agreed to a $3 billion settlement in 2012, and Pfizer promised to pay $784 million in 2016.
Pharmaceutical fraud encompasses a wide range of illicit activities related to the manufacturing, production, marketing, and promotion of drugs. These fraudulent practices aim to exploit governmental programs, such as Medicaid or Medicare, to inflate the value of the drug. Pharma companies have been cited for falsifying drug efficacy data, misrepresenting clinical trial results, promoting off-label uses of drugs, and even offering kickbacks to prescribers. Detecting and combating pharmaceutical fraud is crucial to safeguarding public health and ensuring the integrity of healthcare systems.
These are most common forms of pharmaceutical fraud:
Whistleblower Protection
How To Protect Against Retaliation
Reporting fraud can be a risky task. Whistleblowers often face the legitimate concern of retaliation from their employers. However, there is a ray of hope in the form of the False Claims Act (FCA), which provides protection to those brave enough to expose fraudulent activities. Under the FCA, whistleblowers are shielded from various forms of retaliation, including denial of promotions, demotions, reduction in working hours, suspensions, and even being isolated from important meetings or projects. This protection ensures that whistleblowers can come forward with confidence, knowing that their rights and well-being are safeguarded. A healthcare fraud lawyer at Miller Law Group can help you navigate through it all.
Attorney Stacy Miller discusses the problems healthcare fraud schemes cause and how you can help combat these issues.
About Miller Law Group
About Miller Law Group
Miller Law Group, based in Raleigh, North Carolina, offers a team of highly skilled and experienced healthcare fraud attorneys. We are driven by a commitment to justice and we’re passionate about representing brave whistleblowers ready to come forward with their knowledge of illegal kickbacks, improper billing, or other forms of healthcare fraud. With over 150 years of combined experience, our award-winning attorneys have a proven track record with healthcare fraud cases. Miller Law Group’s aim is to provide exceptional service for our clients navigating whistleblower claims.
