Over $1.1 Billion
In Settlements
Since 2002
Medicare Fraud Whistleblower Attorney
Systemic Government Abuse & Medicare Fraud Hurts Everyone. Report It And Help!
A Medicare fraud whistleblower attorney since 1996, we have been working with whistleblowers to recover Government money. The Bothwell Law Group has an exceptional track record in settlements, whistleblower recovery percentage, and government involvement. Let our team work for you.
MEDICARE & HEALTHCARE FRAUD
Fraud against Medicare hurts the most vulnerable in our society and puts the future of these organizations at risk. Examples of possible fraud include: upcoding; billing for unnecessary procedures; exchanging money, goods, or services for patient referrals; compensating employees or doctors based on referrals; and referring patients to companies the referring provider has a connection to. This list is not exhaustive, and fraudsters are constantly coming up with new methods. If you feel that something is not quite right but are not sure what, please reach out to us. We represent clients at the federal and state level and provide the legal expertise and experience our clients deserve.
WHISTLEBLOWER PROTECTIONS
The False Claims Act provides protection to those who have been retaliated against for relaying concerns (to others in the company or to outside individuals) about possible fraud or for just trying to get the company to follow the law. This is true even if voicing concerns was only part of the reason the person faced retaliation. Retaliation has many different faces. It could mean you were fired, or denied a promotion, or that your work environment became hostile. Whistleblowers who have been retaliated against are entitled to two times back pay and other damages.
QUI TAM LAW
Qui tam is short for a Latin phrase meaning “[he] who sues in this matter for the king as well as for himself.” Qui tam laws allow a private citizen (called a relator) to sue on behalf of the Government. If the relator wins or settles, a certain percentage of the money (up to 30%) will go to the relator as a reward. Qui tam laws are nearly as ancient as the legal system itself, with early examples being found as far back as Ancient Rome. They reflect the unfortunate reality that the government does not have the resources to pursue all wrongdoing.
FALSE CLAIMS ACT
The False Claims Act, or FCA, was signed into law by President Abraham Lincoln following the Civil War to address rampant abuse of Government funds by contractors. The FCA is a qui tam law, meaning it allows private individuals, called relators, to sue on behalf of the Government. If the relator wins or settles, they are entitled to a percentage of the damages (up to 30%), with the rest going to the government to recoup the money stolen. While many FCA cases are Medicare fraud cases, it can be used against any person or company that misuses Government funds. The FCA can even apply to those who cause others to misuse Government funds, for example, a subcontractor who fraudulently bills a contractor for work on a Government project.
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Medical Fraud
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Why Should You Hire A Healthcare Fraud Attorney?
$100 Billion Each Year
Department of Justice states that “More than $100 billion may be lost in fraud, waste and abuse annually. Health care fraud also undermines both the cost and quality of health care provided to patients.”
Anyone in healthcare can commit fraud. From pharmaceutical companies, to healthcare facilities, to medical contractors, financial fraud is common at local, state, and federal levels.
Drug Fraud & Generic Substitutions
Pharmaceutical companies can encourage healthcare providers to prescribe drugs for non-indicated uses. Generic drugs are occasionally substituted and billed at the name-brand rate.
Anti-Kickback Statute (AKS) violations
Anti-Kickback Statute violation is when a medical facility refers patients to a per-determined provider, or a provider prescribes a certain medication, in exchange for compensation.
Billing for medically unnecessary services
Examples of this type of this False Claims Act violation are a doctor billing for cancer treatments for a patient who does not have cancer; a facility admitting patients who do not meet admission criteria, or a pain management doctor who over-prescribes procedures and medications.
Upcoding The Government
A surgeon who performs a simple procedure but bills for a more expensive one; a dentist who pulls one tooth but bills for three; a hospital that submits a false diagnosis that pays more; or an ambulance company bills a routine transport as emergency services; these are all up-coding fraudulently and cost taxpayers money.
Healthcare fraud is rampant in this country and one of the primary bases for False Claims Act cases.
These are just some of the possible claims; there are an endless number of possibilities, with new creative ways to defraud the Government coming out every day.
Medical fraud under the FCA can be against any federal or state provided health insurance, including Medicare, Medicaid, TriCare, Department of Veterans Affairs, federal employee insurance, Railroad Medicare, and Obamacare exchanges.
Taking On Fraudulent Medicare
Our Track Record
Pursuing Justice For
Medical Fraud Cases
Our track record is excellent, in part, because we focus only on whistleblower litigation. Our whistleblower attorneys have extensive experience in locally and nationally regarding Medicare and healthcare fraud cases. We were one of the first firms in the country to show courts that the False Claims Act applies to Medicare and have been on the cutting edge of the law ever since.
This gives us the kind of deep understanding of the pertinent laws and precedents to protect our clients and help them collect appropriate rewards for doing the right thing.
The Bothwell Law Group devotes its practice and resources exclusively to this incredibly complex and compelling area Medicare fraud cases
In past decades, good people faced a tough choice: Endanger their livelihoods and job standing by “blowing the whistle” or allow wrongdoing to continue.
Today, that’s no longer the case. The False Claims Act now protects whistleblowers who expose misuse of government funds, safeguarding their jobs and offering financial rewards. A qui tam statute, enhanced in 1986, specifies that ordinary citizens can now bring cases forward themselves. In filing on the Government’s behalf, you can position yourself to receive a hefty portion of any funds recovered through successful litigation.
Medical fraudulent behavior can violate the federal Stark Law, Anti-Kickback Statute and False Claims Act, as it affected claims made to Medicare, Medicaid, and TRICARE programs.
The Anti-Kickback Statute prohibits offering, paying, soliciting, or receiving remuneration to induce patient referrals covered by Medicare and Medicaid. The Stark Law prohibits hospitals and medical practices from billing Medicare for services referred to entities with which they have a direct or indirect financial relationship.
Here Are Some Common Examples Of Healthcare Fraud Cases We've Represented:
- Up-coding medical billing
- Double Billing
- Billing for non-existent or substandard medical equipment
- Ordering and billing for unneeded services/treatment
- Billing for services never rendered
- Deceptive billings
- Medicare/Medicaid fraud
- Fraudulently retaining over payments
- Enrolling non-existent or ineligible patients
- Falsifying documents
- Recruiting patients for services
- Medicare Advantage and Part C fraud
You Have Whistleblower Protections Under The Law
Law Association Reviews
Your Information Is Privileged & Confidential
As always, your consultation is confidential and privileged, but please be aware that no attorney-client relationship is yet formed by this exchange of information. In other words, we will provide you with a free evaluation of your claim, but we do not represent you yet, even if you send in the information and receive a free consultation.
Should we feel that we can successfully prosecute a claim on your behalf, we will provide you with a written engagement letter outlining the terms of the representation. Regardless of representation, all your information is confidential, protected by the attorney-client privilege, and cannot be used in any way without your permission (and only for your benefit). Contact a Medicare fraud whistleblower attorney today for more information.