Recently, the federal government formerly joined in a whistleblower lawsuit filed against the owners of one Mississippi hospital. The lawsuit alleges that hospital owners unjustly billed over $12 million from Medicare. The lawsuit was filed by a former administrator at Stone County Hospital in 2007. The unsealed complaint alleges that the owners of the hospital paid themselves large salaries that were partially reimbursed by Medicare, the federal health care program for the elderly. Whistleblower James Aldridge stated in the complaint that he rarely witnessed the owners performing management duties, despite the fact that the salaries were included in the cost of running the hospital.
The whistleblower attorneys at Barrett Law, PLLC will follow closely as this lawsuit unfolds. We have assisted whistleblowers in a number of cases against hospitals for wrongful billing and other fraudulent activities. We fight for our whistleblower clients to receive that portion of funds recovered that they deserve. The following is a look at fraudulent healthcare billing and what whistleblowers can do if they uncover this practice.
Healthcare Billing Fraud
Healthcare fraud caused by fraudulent billing is a tremendous problem for government healthcare programs, such as Medicare and Medicaid. For years, Medicare, Medicaid, and like programs have paid untold sums to deceitful healthcare providers. Unscrupulous healthcare providers have created ways to fraudulently bill healthcare programs for their own gain, while defrauding the government at the same time.
Preventing and uncovering healthcare fraud is a central focus of the federal government due to the large impact of healthcare fraud on our overall economy. Whistleblowers are one of the primary avenues by which we combat healthcare fraud. Today, qui tam lawsuits are the number one means of routing out billing fraud.
There are several different ways that fraudulent billing can occur. Some common schemes include:
- Duplicate billing
- Billing for services not provided and goods never delivered
- Split billing or billing for procedures performed in one day over several days
- Upcoding services actually rendered
- Submitting false information or certifications, such as billing for falsified lab reports or certifying contacts as fulfilled when they are not
- Submitting bills to Medicare that should have been paid by other insurers
- Billing for unlicensed or unapproved drugs
- Billing for brand names drugs while instead providing generic drugs
- Billing for top notch equipment, but using inferior equipment
- Inflating billing by using diagnosis codes that suggest more expensive illnesses or treatment
- Billing at doctor’s rates for work performed by an intern or nurse
Whistleblower lawsuits have assisted the federal government in reclaiming billions of dollars from fraudulent healthcare providers. Whistleblowers perform a vital function for the federal government and our entire country. If you have uncovered fraudulent billing occurring in your workplace or a workplace you have contact with, contact a qui tam attorney as soon as possible for assistance with your whistleblower action.
Barrett Law, PLLC: Assisting Brave Whistleblowers Across Mississippi
We need whistleblowers to uncover fraud and wrongdoing occurring in the workplace, but whistleblowers face many challenges in bringing to light the illegal conduct they have discovered. If you are preparing to blow the whistle or have experienced retaliation due to a whistleblowing complaint, contact the Mississippi Whistleblower Attorneys at Barrett Law, PLLC. Our outstanding Mississippi law firm will provide the experienced representation you need to obtain the best possible outcome for your case. Your whistleblower action is time sensitive so contact our office as soon as possible. Call Barrett Law, PLLC today at 1 (800) 707-9577 to schedule your free initial consultation.