Healthcare Fraud
- Date: 2007-08-20 - Word Count: 386
Share This!
Healthcare Fraud
Healthcare fraud may encompass many types of practices such as illegal kickbacks (receiving reimbursement for referrals), billing for services not rendered, billing for unnecessary equipment, and billing for services performed by a lesser qualified person. The health care providers who commit these fraud schemes include hospitals, home health care providers, ambulance services, doctors, chiropractors, laboratories, pharmacies, hospices and nursing homes. A private citizen can file a lawsuit in the name of the United States Government against companies that defraud Medicare and other federal healthcare programs. Medicare is a health program for the elderly financed through a federally-administered trust fund.
Violators may be prosecuted under the False Claims Act ("FCA"). This federal statute was originally passed by Congress in 1863 at the urging of President Abraham Lincoln. He was concerned about the numerous fraudulent suppliers who sold the Union Army faulty war supplies during the Civil War, including broken rifles, rancid food, and useless ammunition. The 1863 FCA provided both criminal and civil penalties for those defrauding the government and therefore was a way to combat the rampant fraud against the government. The FCA also contained a qui tam provision that permitted an individual initiating the suit, the whistleblower, to collect a percentage of the damages. The term qui tam refers to a lengthier Latin phrase which translates into English as "one who sues on behalf of the King, as well as for himself." Many states have passed laws similar to the federal FCA allowing the state to recover damages for fraud against the state Medicaid program. Medicaid is another health program for low-income individuals administered separately by each state.
The whistleblower can only bring a claim in a case in which the government is unaware of the fraud and the information precipitating the action. It is also important for the whistleblower to be the initial source of information regarding the fraud in order to be entitled to a percentage of the damages.
Fraudulent billing and billing for medically unnecessary services is prevalent throughout the United States. Healthcare fraud is expected to increase as people live longer. This increase will produce a greater demand for Medicare benefits. As a result, the utilization of long and short-term care facilities such as skilled nursing, assisted living, and hospice services most likely will expand substantially in the future.
Healthcare fraud may encompass many types of practices such as illegal kickbacks (receiving reimbursement for referrals), billing for services not rendered, billing for unnecessary equipment, and billing for services performed by a lesser qualified person. The health care providers who commit these fraud schemes include hospitals, home health care providers, ambulance services, doctors, chiropractors, laboratories, pharmacies, hospices and nursing homes. A private citizen can file a lawsuit in the name of the United States Government against companies that defraud Medicare and other federal healthcare programs. Medicare is a health program for the elderly financed through a federally-administered trust fund.
Violators may be prosecuted under the False Claims Act ("FCA"). This federal statute was originally passed by Congress in 1863 at the urging of President Abraham Lincoln. He was concerned about the numerous fraudulent suppliers who sold the Union Army faulty war supplies during the Civil War, including broken rifles, rancid food, and useless ammunition. The 1863 FCA provided both criminal and civil penalties for those defrauding the government and therefore was a way to combat the rampant fraud against the government. The FCA also contained a qui tam provision that permitted an individual initiating the suit, the whistleblower, to collect a percentage of the damages. The term qui tam refers to a lengthier Latin phrase which translates into English as "one who sues on behalf of the King, as well as for himself." Many states have passed laws similar to the federal FCA allowing the state to recover damages for fraud against the state Medicaid program. Medicaid is another health program for low-income individuals administered separately by each state.
The whistleblower can only bring a claim in a case in which the government is unaware of the fraud and the information precipitating the action. It is also important for the whistleblower to be the initial source of information regarding the fraud in order to be entitled to a percentage of the damages.
Fraudulent billing and billing for medically unnecessary services is prevalent throughout the United States. Healthcare fraud is expected to increase as people live longer. This increase will produce a greater demand for Medicare benefits. As a result, the utilization of long and short-term care facilities such as skilled nursing, assisted living, and hospice services most likely will expand substantially in the future.
Related Tags: hospitals, medicare, pharmacies, wh, health care providers, federal government, illegal kickbacks, billing for services not rendered, false claims act
Your Article Search Directory : Find in Articles
Recent articles in this category:
- Work Cover Lawyers Help Workers Favored In New Contingency Agreement
Were you ever given a small amount of compensation after having been injured on your job? Have exper - Florida Last Will And Testament Information
A person who is at least 18 years of age can complete a Florida Last Will and Testament and is refer - Florida Durable Power Of Attorney Information
A Florida durable power of attorney is a legal document that designates a person to act on behalf of - California Power Of Attorney Information
In California any adult person who has the ability to enter into an agreement can complete and sign - Criminal Lawyer
Sexual assaults are increasing with alarming frequency and everyday there are news reports about var - Fort Lauderdale Foreclosure Lawyer Explains, Foreclosure Is Not Your Only Option, You Have A Choice
Foreclosure has been one of the foremost topics within the real estate world in recent years, as eac - Should You Make A Personal Injury Claim?
Personal injury claims now gain wider exposure than ever before, yet many people are still unaware o - Mesa Bankruptcy- Regain Financial Stability
Are you drowning in overwhelming debt? Is it causing you mental, emotional and physical distress? Ta - How Bankruptcy Can Help You Financially Start Over With A Clean Slate
Fed up with debt? Desperately want to be free from the unbearable problem? If yes, then you should n - Major Yasmin Birth Control Side Effects
Yasmin is a popular form of hormonal birth control that has been heavily marketed, especially to you
Most viewed articles in this category:
- Be Aware of Single Owner LLC Tax Problems
One of the more popular business entity choices these days is the limited liability company. If - 14 Tips on How Parents Who Have a Child with a Disability Can Organize Their Estate
Copyright © 2007 L. Mark Russell As a general rule, parents should keep their original document - IF OUR PETS WERE REALY OUR "MINOR CHILDREN" MOST OF US "PARENTS" WOULD BE IN JAIL FOR CHILD NEGLECT
As a pet owner, do you need to have a pet trust or will in your estate plan? Well, maybe so, given - The Last Will And Testament - A Model NOT To Live By
The death of Anna Nicole Smith has at least one valuable outcome, even if it is simply serving as a - The British Constitutional Reform Act
The Constitutional Reform Act of 2005 changed the British hitherto unwritten constitution by in - Patented Drugs
While a drug or process is under patent, other companies are wary of working anything even remote - Divorce and Debt
As common sense and statistics tell us, the leading cause of marital discord is money. Therefore - The Misunderstood World of Corporate Minutes
The corporation is the most used form of business entity in the United States. While many people - Attorney for Legal Services
All of us hire lawyers at one point or the other. People get sued, arrested, charged for a crime, - Should Parents EVER Leave an Inheritance Outright to a Child who has a Disability?
Copyright © 2007 L. Mark Russell There are few absolutes in estate planning, but this is one. I
