What is Medicare Fraud?

Medicare fraud occurs when a hospital, nursing home, doctor's office, hospice care facility, ambulance service, pharmacy, rehabilitation center, or any other type of healthcare provider overbills Medicare.


Who can report Medicare fraud?

Medicare fraud whistleblowers are almost always healthcare professionals. They are commonly employed as hospital administrators, nurses, hospice or nursing home workers, ambulance drivers, pharmacists, or as any other type of healthcare professionals.

Receive a financial reward for your information.

Healthcare professionals may be entitled to a significant financial reward for becoming Medicare whistleblowers. Learn about receiving a financial reward for your information here.


History of healthcare and the False Claims Act
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Let’s take a brief look at the meaning and birth of the False Claims Act, or qui tam statute.

What is Medicare Fraud?
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Unfortunately, Medicare fraud is big business. Illegal, yes, but big business nonetheless. The US Office of Management and Budget says “improper payments” made by Medicare in 2010 amounted to more than $47.8 billion. That represents almost 10% of the $528 billion total Medicare spend that year. In the current era of shrinking budgets and unbalanced budgets, the US simply cannot afford to allow this level of fraud.

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