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