| Healthcare Fraud | | | | |
| Healthcare fraud may encompass many types of | | | | The whistleblower can only bring a claim in a case in |
| practices such as illegal kickbacks (receiving | | | | which the government is unaware of the fraud and |
| reimbursement for referrals), billing for services not | | | | the information precipitating the action. It is also |
| rendered, billing for unnecessary equipment, and billing | | | | important for the whistleblower to be the initial |
| for services performed by a lesser qualified person. | | | | source of information regarding the fraud in order to |
| The health care providers who commit these fraud | | | | be entitled to a percentage of the damages. |
| schemes include hospitals, home health care | | | | Fraudulent billing and billing for medically unnecessary |
| providers, ambulance services, doctors, chiropractors, | | | | services is prevalent throughout the United States. |
| laboratories, pharmacies, hospices and nursing homes. | | | | Healthcare fraud is expected to increase as people |
| A private citizen can file a lawsuit in the name of the | | | | live longer. This increase will produce a greater |
| United States Government against companies that | | | | demand for Medicare benefits. As a result, the |
| defraud Medicare and other federal healthcare | | | | utilization of long and short-term care facilities such as |
| programs. Medicare is a health program for the | | | | skilled nursing, assisted living, and hospice services |
| elderly financed through a federally-administered trust | | | | most likely will expand substantially in the future. |
| fund. | | | | |