Medicaid Fraud Whistleblower Reward Lawsuits against large drug companies, health care systems, hospitals, and medical device manufacturers are on the rise as Medicaid Fraud Whistleblowers are stepping forward to blow the whistle on large fraudulent marketing scams to defraud the state Medicaid systems are being exposed. With new whistleblower protections and strong financial incentives, physicians, hospital administrators, benefit coordinators, state auditors, and other or health care professionals are working with State attorney generals and private Medicaid fraud whistleblower lawyers to expose systematic Medicaid fraud, For more information on Medicaid fraud whistleblower reward lawsuits, feel free to contact Texas Medicaid Fraud Lawyer, Jason Coomer via e-mail message or use our submission form.
New State Medicaid Whistleblower Reward Laws Allow Medicaid Fraud Whistleblower Lawyers, Medicaid Hospital Employee Whistleblower Reward Lawyers, Hospital Whistleblower Lawyers, and Hospital Medicaid Fraud Whistleblower Lawyers to Protect Hospital Employee Whistleblowers From Retaliation
New state whistleblower reward laws are expanding the ability of Medicaid fraud whistleblowers to collect large economic rewards to encourage health care providers to blow the whistle on health care fraud including illegal Medicaid retention of overpayments, Medicaid illegal kickback schemes, Medicaid upcoding practices, Medicaid double billing practices, Medicaid false coding practices, Medicaid unbundling, and other fraudulent Medicaid billing practices.
The 2009 Fraud Enforcement and Recovery Act (FERA) and many new state Medicaid fraud whistleblower laws are expanding Medicaid fraud whistleblower recovery laws and other Bounty Reward Actions to increase potential rewards for relators, expand potential liability for Medicaid fraud criminals and violators, and to increase protections to Medicaid fraud whistleblowers. These new laws are designed to help the Federal government and state governments identify, recoup, and crack down on Medicaid fraud, Medicare fraud, and other forms of health care fraud which is estimated to be over $100 Billion per year.
With Medicare and Medicaid costs continuing to grow and many government budgets being tight, it is essential that health care providers with knowledge of Medicaid fraud, Medicare fraud, or other health care fraud to step up and expose the health care fraud and systematic Medicaid fraud that is the fasting growing and most lucrative crimes in the United States.
In developing and strengthening Medicaid fraud whistleblower laws, governments are setting up increased whistleblower protections and economic incentives to encourage health care providers to blow the whistle on traditional qui tam health care fraud causes of action and are expanding the causes of action to include rewards to whistleblowers that expose retention of Medicaid overpayments. Many of these False Claims Act statutes and Medicaid Fraud statutes have also been expanded to include government contractor false claims, government grantee false claims, and other recipients of government money that submit false claims to obtain this money.
For more information on potential Medicaid fraud whistleblower recoveries and Medicaid fraud whistleblower protections, it is important to contact a Medicaid fraud whistleblower reward lawyer, Medicaid illegal kickback whistleblower reward lawyer, Medicaid upcoding whistleblower reward lawyer, Medicaid protected whistleblower double billing lawyer, Medicaid false coding whistleblower reward lawyer, Medicaid unbundling fraud whistleblower lawyer, or other health care fraud whistleblower lawyer to maximize your ability to obtain a substantial whistleblower recovery and understand whistleblower protections from potential retaliation.
Public Health Programs are the Target of Systematic Billing Fraud, Drug Marketing Fraud, and Other Fraudulent Schemes to Systematically Bill Medicaid, CHIP, Medicare, and other Public Health Programs for Unnecessary Treatment, Improper Treatment, Defective Drugs, Inferior Products, and Double Billing Scams
Medicaid, Medicare, CHIP, and other public health programs have become targets for some greedy health care professionals in large "for profit" corporations that are seeking to maximize their profits and income through fraudulent practices. These greedy health care professionals are in several large corporations including drug manufacturers, medical device manufacturers, hospitals, health care systems, nursing homes, dental clinics, and other large for profit health care providers. These unscrupulous health care professionals use Medicaid marketing fraud, misrepresentation of drug research, fraudulent coding practices, double billing, false certifications, and other complicated fraud schemes to illegally take money from Medicaid, Medicare, CHIP, and other public health programs. By using fraudulent practices to obtain higher profits and further their careers, these health care providers are endangering their health care company's ability to continue to receive Medicaid and Medicare benefits as well as jeopardizing their co-workers who could be subject to criminal prosecution for fraudulent Medicaid practices and fraudulent Medicare practices.
These fraudulent health care professionals will often fraudulently manipulate billing practices, medical billing statements and coding information to maximize Medicaid payments, Medicare payments, and insurance payments. Many of these fraudulent health care professionals will also push unnecessary medical services regardless of the needs of their patients. To these fraudulent health care professionals, patients are numbers to be billed as much as possible including billing for the most expensive tests and treatments regardless of medical justification or even if the service is actually provided. In health care systems run by fraudulent health care professionals, doctors are viewed as billing machines that need to maximize the number of patients treated and services provided.
Below are some common types of Medicaid fraud:
To many of these fraudulent health care providers, public health programs are the source of millions or billions of dollars that can be turned into profits. As these fraudulent "for profit" health care providers are finding new ways to manipulate and defraud the medical industry, good health care providers are being hurt by the system.
When "for profit" health care providers start to commit fraud including upcoding, billing for services not provided, billing for unnecessary services, double billing, triple billing, or falsely certifying services, they cross the line into Medicaid billing fraud, it is important that Medicaid Fraud Whistleblowers step forward to expose the Medicaid fraud.
By working with a Medicaid Billing Fraud Whistleblower Lawyer, these Medicaid Fraud whistleblowers can not only help protect themselves from potential retaliation, but can also work to become a relator under Federal and/or state False Claims Act laws to collect a portion of the money that is recovered from the fraudulent health care provider.
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Medicaid fraud violates federal and state criminal laws and can result in significant fines and/or incarceration. Those convicted of fraud may also lose their status as Medicaid providers. To prevent Medicaid fraud, Texas has enacted the Texas False Claims Act and Medicaid Fraud Prevention Act. Medicaid is a public health care problem in the United States that provides health care, dental care, and orthodontic care for eligible individuals and families with low incomes and resources. The Medicaid Program is jointly funded by state and federal governments, but is managed by the states. Medicaid is the largest source of funding for medical and health-related services for people with limited income in the United States and the Medicaid program has been increasing. The fastest growing aspect of Medicaid is nursing home coverage and this is expected to continue as the Baby Boomer generation begins to reach nursing home age.
Unlike Medicare, which is solely a federal program, Medicaid is a joint federal-state program. Each state operates its own Medicaid system. Each state's Medicaid Program must conform to federal guidelines in order for the state to receive matching funds and grants. For many states Medicaid has become a major budget issue as on average the state's matching costs of the Medicaid program is about 16.8% of state general funds. According to CMS, the Medicaid program provided health care services to more than 46.0 million people in 2001. In 2008, Medicaid provided health coverage and services to approximately 49 million low-income children, pregnant women, elderly persons, and disabled individuals. Federal Medicaid outlays were estimated to be $204 billion in 2008. Medicaid payments currently assist nearly 60 percent of all nursing home residents and about 37 percent of all childbirths in the United States. The Federal Government pays on average 57 percent of Medicaid expenses.
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The Texas False Claims Act is designed to prevent Medicaid Fraud including false Medicaid billing, fraudulent Medicaid billing, Medicaid kickbacks, billing Medicaid for patients that have died, and phantom Medicaid billing. The Act offers large financial rewards to whistleblowers that properly report instances of significant Medicaid fraud. If you are aware of Texas Medicaid kickbacks, Texas fraudulent Medicaid billing, or other Texas Medicaid fraud, and are the original source of information with special knowledge, and evidence of the fraud, please feel free to contact Texas False Claims Act Medicaid Fraud Whistleblower Recovery Lawyer Jason Coomer via e-mail message or use our submission form.
Texas Medicaid Whistleblowers with Original and Specialized Information of Medicaid Fraud Are Eligible to Collect Large Financial Rewards for Filing Texas False Claims Act Lawsuits, Texas Medicaid Fraud Whistleblower Recovery Lawsuits, Texas Medicaid False Billing Whistleblower Award Lawsuits, Texas Medicaid Double Billing Fraud Lawsuits, Texas Medicaid Fraud False Billing Lawsuits, Texas Unnecessary Medical Treatment Relator Lawsuits, and Texas Medicaid Fraud Whistleblower Lawsuits
Medical professionals as insiders with original and specialized information of Medicaid fraud are needed to step forward to help expose and prevent Medicaid fraud. As such, the state of Texas has enacted Whistleblower Reward laws that provide economic incentives for Texas Medicaid Fraud Whistleblowers with original and specialized information of Medicaid fraud and Medicaid kickbacks. With the help of a Texas Medicaid fraud lawyer, these Texas Medicaid fraud whistleblowers can help expose and prevent Medicaid fraud, as well as can also recover a portion of the money collected from the fraudulent health care providers.
With the enactment of these Texas Whistleblower Reward laws, it is becoming more common for Texas Dentist Medicaid Fraud Whistleblowers, Medical Clinic Medicaid Fraud Whistleblowers, Texas Hospital CEO Whistleblowers, Texas Hospital System CFO Whistleblowers, Texas Benefit Coordinator Whistleblowers, Texas Health Care Book Keeper Whistleblowers, and other Texas Medicaid Fraud Whistleblowers to come forward and expose Medicaid Fraud and fraudulent billing schemes.
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If you are a hospital administrator, nursing home administrator, physician, nurse, respiratory therapist, coder, accountant, dentist, health care coordinator, coding specialist, or other health care professional that is aware of Medicare fraud, it is important that you report the Medicare fraud. As a Medicare fraud whistleblower you can recover a portion of the recovery if the fraud is properly reported. Medicare Fraud Whistleblowers can only recover a large financial reward, if they are the original source of knowledge, the first to file, and a successful relator of a Medicare Fraud Lawsuit.
If you have evidence of significant systematic Medicaid Fraud or systematic Medicare Fraud, it is important that you properly report that the systematic Medicare fraud or systematic Medicaid fraud, so that you can potentially recover a portion of the money recovered from the fraudulent health care provider.
There are several keys to a successful False Claims Act Qui Tam Whistleblower action including 1) obtaining original and specialized information of the fraud, 2) being the first to file regarding the specific fraud, and 3) protecting the whistleblower for retaliation.
Original and Specialized Information of Fraud is Essential for Medicaid Coding Whistleblower Lawsuits, Medicaid Reimbursement Whistleblower Lawsuits, Medicaid Compliance Whistleblower Lawsuits, and Medicaid Marketing Fraud and Kickback Lawsuits
As insiders it is common for hospital administrators, doctors, nurses, accountings, coders, billing specials, compliance specialist, and other health care professionals to have specialized knowledge of Medicaid fraud, systematic Medicaid Fraud, and fraudulent Medicaid schemes. As such, it is important for the systematic Medicaid fraud whistleblowers to obtain and preserve evidence of the Medicaid fraud. Whether this evidence is in e-mail messages, memos, marketing plans, marketing materials, recordings, or other documents, it is important for the whistleblower to have evidence of the systematic Medicaid fraud. It is also often helpful to have fellow whistleblowers that can help build the Medicaid Fraud case.
Being the First to File on the Fraud is Essential for Recovery Under the False Claims Act and can Prevent Potential Criminal Liability in Medicaid Fraud Scams, Medicaid Reimbursement Fraud Scams, Systematic Medicaid Fraud Scams, & Medicaid Fraud Kickback Scams
It is also essential to not delay in coming forward with a False Claim Act Medicaid Fraud Whistleblower Action as the first whistleblower to file is eligible to be a relator and make a large recovery for exposing the fraud. Additionally, when the fraudulent scheme is exposed, the people that kept the fraud secret can sometimes be found liable for criminal activity for not exposing the fraud that was being committed and further be held liable for continuing criminal activity.
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Texas Medicare Fraud Lawyer, Jason S. Coomer, is working with Medicare Fraud Whistleblowers to expose Medicare fraud and blow the whistle on criminals that are fraudulently stealing from the United States and the Medicare program.
Below are several press releases regarding Medicare Fraud.
More Than $1 Billion Recovered by Justice Department in Fraud and False Claims in Fiscal Year 2008 More Than $21 Billion Recovered Since 1986
WASHINGTON - The United States secured $1.34 billion in settlements and judgments in the fiscal year ending Sept. 30, 2008, pursuing allegations of fraud against the federal government, the Justice Department announced today. This brings total recoveries since 1986, when Congress substantially strengthened the civil False Claims Act, to more than $21 billion.
"Now, more than ever, it is crucial that taxpayer dollars aren't lost to fraud," said Gregory G. Katsas, Assistant Attorney General for the Department's Civil Division. "The billion dollars collected this year is only part of the story. By rooting out fraud and vigorously pursuing it, the Department, with the help of concerned citizens who report fraud in hotline calls and in qui tam complaints, undoubtedly saves the country many times that amount in aborted schemes and misconduct."
Assistant Attorney General Katsas also paid tribute to Senator Charles Grassley of Iowa and Representative Howard L. Berman of California who sponsored the 1986 amendments to the False Claims Act, the government's primary weapon to fight government fraud. "Without this important legislation strengthening the Act and, in particular, the qui tam provisions which encourage private citizens to uncover government fraud, such recoveries would not have been possible."
Almost 78 percent of this year's recoveries are associated with suits initiated by private citizens (known as "relators") under the False Claims Act's qui tam provisions. These provisions authorize relators to file suit on behalf of the United States against those who have falsely or fraudulently claimed federal funds. Such cases run the gamut of federally funded programs from Medicare and Medicaid to defense procurement contracts, disaster assistance loans and agricultural subsidies. Persons who knowingly make false claims for federal funds are liable for three times the government's loss plus a civil penalty of $5,500 to $11,000 for each claim.
Relators recover 15 to 25 percent of the proceeds of a successful suit if the United States intervenes in the qui tam action, and up to 30 percent if the government declines and the relator pursues the action alone. In fiscal year 2008, relators were awarded $198 million. (This figure does not include relator shares awarded after Sept. 30, 2008.)
As in the last several years, health care accounted for the lion's share of fraud settlements and judgments-$1.12 billion. This number includes both qui tam claims and those initiated by the United States. The Department of Health and Human Services reaped the biggest recoveries, largely attributable to its Medicare program and the federal/state Medicaid program which funds health care for the needy. Recoveries were also made by the Office of Personnel Management which administers the Federal Employees Health Benefits Program, the Department of Defense for its TRICARE insurance program, the Department of Veterans Affairs and others.
The largest health care recoveries came from pharmaceutical companies and related entities. Settlements with Cephalon Inc., Merck & Co. and CVS Caremark Corp. accounted for more than $640 million. In addition to federal recoveries, these pharmaceutical fraud cases returned $430 million to state Medicaid programs.
The Civil Division's investigation of the pharmaceutical industry is part of a Department-wide effort. Typical allegations include "off-label" marketing, which is the illegal promotion of drugs or devices that are billed to Medicare and other federal health care programs, for uses that were neither found safe and effective by the Food and Drug Administration nor supported by the medical literature; paying kickbacks to physicians, wholesalers and pharmacies to induce drug or device purchases; establishing inflated drug prices knowing that federal health care programs use these prices to reimburse providers, then marketing the "spread" between the federal reimbursement and the provider's lower cost to induce drug purchases; and knowingly failing to report the company's true "best price" for a drug to reduce rebates owed to the Medicaid program.
The Department also collected $133 million in defense procurement fraud. Defense contract recoveries included a $53 million settlement with Pratt & Whitney, a division of United Technologies Corporation, and PCC Airfoils LLC, a subsidiary of Precision Castparts Corporation. The settlement resolved allegations that Pratt & Whitney and PCC Airfoils knowingly submitted false claims to the Air Force for defective turbine blades sold to the government to retrofit the F100-PW-220 engines in F-16 and F-15 aircraft. This case was pursued as part of a National Procurement Fraud initiative, launched in October 2006, to promote the early detection, identification, prevention and prosecution of procurement fraud.
FACT SHEET: SIGNIFICANT RECOVERIES IN FISCAL YEAR 2008
Among the Department's most significant settlements and judgments in fiscal year 2008 were:
* $361.5 million from Merck & Company to resolve allegations that the pharmaceutical manufacturer knowingly failed to pay proper rebates to Medicaid and other government health care programs, and paid kickbacks to health care providers to induce them to prescribe the company's products. The settlement resulted from two lawsuits brought under the qui tam provisions of the False Claims Act.
In the first, which accounted for $221.9 million of the $361.5 settlement, a former Merck employee alleged that the company violated the Medicaid Rebate Statute by providing deep discounts to hospitals that used its drugs Zocor and Vioxx in place of competitors' brands, without reporting those discounts and other cost information to reflect its "best price," as required by the statute to ensure that Medicaid obtains the benefit of the same price concessions other purchasers enjoy. This suit also alleged that Merck paid kickbacks to physicians, disguised as fees for training, consultation, and market research, to induce them to prescribe its drugs, also contrary to law. The United States paid the relator $46.6 million as his share of the settlement under the False Claims Act's qui tam provisions. In addition to the federal recovery, Merck paid $162 million to state Medicaid programs.
In the second lawsuit, which accounted for the remaining $139.6 million of the settlement, a physician alleged that Merck provided deep discounts to hospitals to induce them to administer its antacid, Pepcid, as a means to boost sales through continued use after the patient's discharge. The suit went on to allege, similar to the first suit, that Merck knowingly failed to report these discounts as required by the Medicaid Rebate Statute, which resulted in illegal and inflated claims to federal and state Medicaid programs. In addition to paying the United States $139.5 million in federal claims, Merck paid $114 million to settle state Medicaid claims. The relator received $24 million as his federal share of the settlement and an additional sum for the state recoveries. Merck also entered into a Corporate Integrity Agreement with the Inspector General of the Department of Health and Human Services (HHS) to ensure compliance with federal health insurance programs in the future.
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As a Texas Federal False Claims Act Whistleblower Lawyer Jason Coomer handles Medicare fraud lawsuits, Medicaid fraud lawsuits, defense contractor fraud lawsuits, securities fraud bounty actions, Medicare fraud whistleblower lawsuits, dentist CHIP fraud and Medicaid fraud lawsuits, IRS fraud lawsuits, Texas breach of fiduciary duty lawsuits, and other Qui Tam lawsuits. He also works with other Medicare fraud lawyers and False Claims Act lawyers throughout Texas and the United States on large False Claims Act Lawsuits.
For more information on False Claim Act Lawsuits, please go to the following web pages:
Medicaid Coding Whistleblower Protection, Medicaid Reimbursement Whistleblower Protection, Medicaid Compliance Whistleblower Protection, and Medicaid Hospital Executive Whistleblower Protection under the Federal False Claims Act
It is also important to understand potential whistleblower protections under the False Claims Act and to discuss with an attorney how to prepare for potential retaliation or aggressive attacks by the employer or contractor. For more information on this topic please go to the following web page on False Claims Act Lawsuit Whistleblower Protections.
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Health care companies that are committing Medicare fraud scams are being brought to justice by whistleblowers and law enforcement. Medicare Fraud Lawyer Jason Coomer is working with other powerful Texas Medicare fraud lawyers to help Medicare fraud whistleblowers blow the whistle on systematic Medicare fraud. He works with San Antonio Medicare Fraud Lawyers, Dallas Medicare Fraud Lawyers, Houston Medicare Fraud Lawyers, El Paso Medicare Fraud Lawyers, and other Texas Medicare Fraud Lawyers as well as with Medicare Fraud Lawyers throughout the nation to blow the whistle on fraud that hurts the United States.
If you are aware of systematic Medicare fraud and are the original source knowledge of Medicare Fraud, it is important that you are the first to step forward to blow the whistle on the systematic Medicare fraud. If you are a Medicare Fraud Whistleblower that has evidence of a fraudulent Medicaid billing scam, a Medicare kickback scam, Medicaid kickbacks, or other systematic Medicare fraud, feel free to contact Medicare Fraud Lawyer Jason Coomer via e-mail message or our submission form.
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It is extremely important that Medical Professionals, Hospital Administrators, Benefit Coordinators, Accountants, and other Whistle Blowers continue to expose fraudulent billing practices, kickback arrangements, Federal Health Care Program Referrals, Federal Health Care Program Medical Supply Bribery Rings, and unnecessary treatments that cost hundreds of billions of dollars.
Texas Medicaid Fraud Lawyer Jason S. Coomer commonly works with other Texas Medicaid Fraud Whistleblower Lawyers, Medicaid Fraudulent Kickback Whistleblower Lawyers, Hospital Employee Medicaid Fraud Whistleblower Lawyers, Medicaid Fraud Illegal Hospital Kickback Whistleblowers Lawyers, and Other Medicaid Fraud Whistleblower Reward Lawyers. If you are aware of a large health care company or individual that is defrauding the United States Government out of millions or billions of dollars, it is important that you blow the expose the fraud. For more information on Medicaid fraud whistleblower reward lawsuits, feel free to contact Texas Medicaid Fraud Lawyer, Jason Coomer via e-mail message or use our submission form. As a Texas Medicaid Fraud Whistleblower Lawyer, he commonly works with litigation teams of powerful qui tam lawyers that handle large Health Care Government Fraud Federal False Claims Act cases throughout the nation to blow the whistle on fraud that hurts the United States.
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