Medicare in the United States is defined as “the federal health insurance program for people who are 65 years of age or older, and for specific other designated groups of people in need”. Medicare started in the United States in July 1965, when then President Lyndon B. Johnson made Medicare coverage a federal law.
Medicare fraud occurs when someone makes a claim for Medicare payment that is false and unwarranted. The goal of someone who purposefully performs Medicare fraud is to receive government money that is not legally theirs to claim. A person who is convicted of Medicare fraud may face significant amounts of prison time, restitution, monetary fines, or even deportation (if they are not an American citizen).
There are many different types of Medicare fraud, but the main ones fall in to these three categories:
-Upcoding: the technique of falsifying medical billing codes, in order to receive more money from the Medicare program than was actually owed.
-Phantom billing: when the healthcare provider bills Medicare for procedures or diagnostic tests on a patient that were unnecessary or were never performed, or when expensive medical equipment is stated in use for a particular patient but was never used.
-Patient billing: when a patient is “in” on the fraud, and makes claims that they received medical treatment, when, in fact, they did not. Often a patient will provide the medical personnel with their own individual Medicare number willingly, with the intent of receiving kickbacks from said medical personnel.
Medicare fraud costs the federal government billions of dollars per year; however, federal investigators are diligently working to decrease that number. Note that any individual has the right and the freedom to report suspected Medicare fraud, without fear of retaliation. In fact, government officials rely tremendously on assistance from “whistleblowers” to help track down those individuals or groups that have potentially participated in Medicare fraud.
If you suspect the occurrence of Medicare fraud, there are several ways that you can help stop Medicare abusers in their tracks. You can call the national Medicare fraud hotline at 1-800-447-8477, or, throughout the state of Florida only, you can call the Florida Medicare fraud hotline at 1-866-417-2078. You can also email Florida investigators at email@example.com. Be sure to choose Seitles & Litwin when you are in need of effective counsel! ” Experience You Can Trust!” Call Now (305) 403-8070