Medical facilities that participate in billing fraud may be liable under the False Claims Act. Whistleblowers who report healthcare billing fraud can receive protection and an award under the False Claim Act.
The federal False Claim Act and the North Carolina False Claims Act were enacted to prevent fraud against government programs. To encourage whistleblowers to report fraud, the False Claims Act incentivizes whistleblowers by allowing whistleblowers to receive a percentage of any recovery. The FCA also gives whistleblowers protection against workplace retaliation for reporting fraud.
The most common type of fraud against government programs is healthcare fraud, specifically Medicare and Medicaid fraud. Some common fraudulent schemes include:
- Up coding, double billing, Unbundling
- Billing for services that are not medically necessary
- Billing for services that are not provided
- Accepting kickbacks
To report healthcare fraud, 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. It is important to speak with an experienced whistleblower lawyer prior to reporting the wrongdoing or fraud. Failure to follow the guidelines of the False Claims Act may result in a whistleblower forfeiting any recovery.
For a free consultation, contact Miller Law Group – or call 919-348-4361.