When people are in their final months of life they often go into hospice care. Hospice care is emotional support and pain management for patients with less than six months to live. The money to pay for hospice care is often paid through Medicare, a federal program.
Hospice is a fraught time for most families. Their loved one is about to die and they are often overwhelmed with the many tasks involved in caring for their loved one, dealing with health-related expenses, and the pain of impending loss. As a result, they do not closely watch expenses. Unfortunately, because of the high cost of medical care, this is a ripe moment for Medicare fraud. Because the patient has usually died by the time any discrepancy arises and the family is in no position to remember precisely what medication was given or therapy performed, it can be challenging to detect over-billing or billing for treatments that never occurred. This difficulty is compounded because the majority of hospice care happens in a patient’s home, where the standard controls present in a hospital environment may not be as robust.
If you have witnessed the sort of Medicaid fraud I described above, you may be able to file a False Claims Act whistleblower claim. The Federal False Claims Act (31 U.S.C. §§ 3729-3733) is a law that penalizes individuals and companies that are convicted of defrauding the government. “Whistleblower” is a general term for a private citizen who wants to alert the government to fraudulent acts committed against the government. In return for taking the substantial risks involved with exposing that fraud, whistleblowers can recover 15% to 30% of whatever funds the federal government recovers, amounts that often reach well into the millions.
Fraud in the Hospice Environment
If you work in hospice, you know that it is medication-intensive. The United States and Mississippi are both suffering from the effects of an opioid epidemic. Given that the pain management aspects of hospice often involve opioids, there is a tremendous opportunity to steal or divert medications and resell them on the black market. Similarly, because the patient will likely die shortly after hospice, it is ripe for overbilling and billing for procedures that were not performed.
If you are contemplating becoming a whistleblower in the hospice context, you will likely need to gather a sizable amount of evidence to support your claim. Especially if you are reporting a medical provider’s practice of overbilling, keeping careful notes regarding what treatment did and did not occur will be vital.
To attain any reward as a whistleblower, you must be the “first to file.” You can remain anonymous for a short period, but if the federal government decides to prosecute your case, your name will become public. As a result, you should be prepared for significant backlash for your actions. However, retaliation is prohibited under the False Claims Act, and retaliation has its own financial penalties for employers who take adverse action against whistleblowers.
What Should You Do if You are Considering a Whistleblower Claim?
Do you have knowledge of fraud or other serious financial misconduct occurring in hospice care? Are you considering filing a whistleblower case? To protect your career and family and to attain your compensation, you will require the help of an experienced whistleblower attorney. Because whistleblower programs receive thousands of tips each year, they can only act on a small percentage. If you are going to risk your career, relationships, and livelihood, you want to make your work count.
Call Barrett Law now at (601) 790-1505 if you think you may be a whistleblower.
Experienced Mississippi Whistleblower Lawyer Jonathan Barrett can provide you with the advice you will need to file a successful False Claims Act case. Having expert legal advice by your side can mean the difference between receiving your share of a whistleblower judgement and losing your career and livelihood. Call today.