Medicaid is a taxpayer-supported federal program that enables low-earning Americans to obtain health coverage. Therefore, when a healthcare provider or insurer manipulates the admittedly complicated system to reap financial benefit, taxpayers take the hit. It is essential to stay on top of this kind of illegal activity and to protect those whistleblowers who have the morality and courage to step forward.
What Is A Whistleblower?
Individuals who have information concerning illegal Medicaid fraud are called whistleblowers when they turn this information over to authorities. In both Medicaid and Medicare fraud cases, these individuals are generally employees of health care providers or insurers.
Provider fraud. Health care providers are sometimes involved in Medicaid fraud. There have been cases where doctor’s offices, hospitals and medical care facilities were overbilling Medicaid or billing for services that were never provided.
Insurer fraud. Health insurers who handle Medicaid or Medicare may also be involved in illegal activity. One such case recently occurred involving the nation’s largest health insurer: UnitedHealth Group Inc. UnitedHealth is currently in federal court with the U.S. Justice Department, which has claimed that the insurer used inaccurate patient health statuses to obtain inflated government payments through their Medicare Advantage Plan. According to the complaint document, UnitedHealth submitted claims for increased Medicare payments from the government based on diagnosis codes that they knew to be incorrect.
What If I Have Information About Medicaid Fraud?
If you have information concerning Medicaid fraud, you should come forward. If you’re worried about the sensitive position you may be in for turning in your employer for illegal activity, this is certainly a legitimate concern.
But being fearful about the ramifications that may ensue shouldn’t stop you from doing it. You can protect yourself by contacting a reputable lawyer who can support and represent you. In this way, you can do the right thing while taking steps to ensure your own well-being.