MEDICAID & MEDICARE FRAUD
Chirolegal Resources represents “whistleblowers” who come forward in Medicare false claims and fraud cases. These cases may also known as Qui Tam cases.
Under the False Claims Act, if you are a private individual who becomes aware that a company is defrauding the federal government or the Commonwealth of Massachusetts, you can bring suit against the company or individual for the fraud on behalf of either or both of these governments. If the suit is successful, you can receive a percentage of what is recovered. We represent private individuals in such suits involving Medicare or Medicaid.
Examples of cases that fall under the False Claims Act include fraudulent Medicare billing, fraudulent Medicaid billing.
How Does Medicare Define "Fraud" and "Abuse”?
Medicare fraud is defined as:
“The intentional deception or misrepresentation that an individual knows to be false or does not believe to be true and makes, knowing that the deception could result in some unauthorized benefit to himself/herself or some other person.”
The most frequent kind of fraud arises from a false statement or misrepresentation made, or caused to be made, that is material to entitlement or payment under the Medicare program. The violator may be a physician or other practitioner, a supplier of durable medical equipment, an employee of a physician or supplier, a billing service, a beneficiary, or any other person or business entity in a position to bill the Medicare program or to otherwise benefit from such billing.
Medicare abuse is defined as:
"Incidents or practices of physicians or suppliers of equipment which, although not usually considered fraudulent, are inconsistent with accepted sound medical, business or fiscal practices.”
It is the providers' responsibility to stay current with Medicare rules and regulations and to ensure administrative personnel understand Medicare guidelines as they pertain to coding and billing of services provided.
Call us first toll-free at 1.508.776.6526 for a free initial consultation
If you believe that you may have information that an organization or person is defrauding the government, do not hesitate to contact us. Call us toll-free at 1.508.776.6526 for a free initial consultation.