Submitting fraudulent medical bills to any federal or state programs, like Medicare and Medicaid, is a violation of both the federal False Claims Act and the North Carolina False Claims Act.  The consequences could include substantial fines, treble damages, and possible criminal prosecution.

Whistleblowers who report billing fraud are protected under North Carolina and federal False Claims Acts.  The encourage whistleblowers to report fraudulent billing practices, the FCA allows whistleblowers to receive a percentage of any recovery.

Examples of medical billing fraud include:

  • Up coding, double billing, Unbundling
  • Billing for services that are not medically necessary
  • Billing for services that are not provided
  • Accepting kickbacks

If you are aware of fraudulent billing, it is important to speak with an experienced whistleblower lawyer before reporting the fraud.  If the fraud is not reported correctly, a whistleblower may forfeit any rights to an award.

Under the False Claims Act, whistleblowers are required to file claims called “qui tam” lawsuits.  Qui tam lawsuits are filed on behalf of the state or federal government and are filed under seal.  The cases are filed under seal to give the government an opportunity to investigate the claim and decide whether to intervene.

Miller Law Group has experience representing whistleblowers throughout the state of North Carolina and the southeast.  For a free consultation, contact Miller Law Group – or call 919-348-4361.

Medicare Fraud Whistleblower – Paying Patient Co-pays

COVID-19 Tests and Medicare Fraud

Medicare and Medicaid Fraud: Charging Excessive Prices