Three California whistleblowers have helped the government recover $16.7 million after uncovering a Medicare upcoding scheme.

According to the Department of Justice press release, a 27 locations skilled nursing facility defrauded Medicare and Medicaid by upcoding for its rehabilitation therapy services.  These services can be billed to government funded healthcare programs under various codes based on the level of services rendered.  According to the whistleblowers’ allegation, the company systematically billed under “Ultra High” codes, regardless of the actual services provided or the actual medical need for those services.

The False Claims Act (FCA) allows individuals who have uncovered fraud against government programs, like Medicare and Medicaid, to bring civil actions to recover public funds.  Whistleblowers are entitled to share in any recovery, and receive important protections from retaliation.  In the present case, the three whistleblowers will receive over $3 million for bringing the allegations of fraud to light.

If you have uncovered fraud against the government, contact the whistleblower lawyers at Miller Law Group today for a free and confidential consultation.  You can also set up a consultation by calling us at (919) 348-4361.

The settlement discussed above is based on allegations only.  No determination of liability has been made.

Additional Resources

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