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Florida Healthcare Fraud Lawyer

Fraud-based crimes involve the use of deliberate and dishonest tactics to obtain a benefit. When it comes to the healthcare industry, these types of offenses can have especially far-reaching consequences, resulting in the estimated loss of billions of dollars a year in federal healthcare funds. Although most healthcare fraud claims involve allegations of deceptive billing practices, there are actually a wide range of actions that fall under this broad category, so if you believe that an employer may be engaging in fraudulent billing practices or is otherwise engaged in unethical activity, you should speak with an experienced Florida healthcare fraud lawyer who can evaluate your case and advise you accordingly.

Filing False Healthcare Claims

Healthcare fraud can take a number of different forms, but typically involves the filing of false healthcare claims, which includes:

  • Billing insurers and federal healthcare programs for services never rendered;
  • Billing for services or products that were not medically necessary;
  • Filing duplicate claims for the same service;
  • Billing for non-covered care;
  • Falsifying a patient’s diagnosis to justify surgeries, tests, or other unnecessary procedures;
  • Misrepresenting the type or level of care provided;
  • Incorrectly reporting diagnoses and procedures to maximize payment;
  • Waiving patient copays and overcharging the insurer;
  • Unbundling, or charging an insurer separately for services that are usually charged as a single procedure; and
  • Seeking reimbursement for services that have been incorrectly billed at a higher rate.

Using deceptive billing practices is not, however, the only type of healthcare fraud, which also encompasses dishonest, unethical, and illegal practices like hiring unlicensed staff, accepting or offering kickbacks for referrals, promoting drugs for non-covered uses, falsely inflating drug prices, and providing false information about diagnoses and electronic health record capabilities.

Liable Healthcare Providers

Although individual doctors can be held liable for engaging in deceptive practices, these are not the only kinds of healthcare providers who can be charged with fraud. In fact, some of the most costly and egregious forms of healthcare fraud are committed by pharmaceutical manufacturers, hospital chains, pharmacies, medical device companies, and physician practices.

Fortunately, it is possible for those with insider knowledge of the fraud being committed, to force individuals and entities that engage in deceptive practices, to compensate the government for their actions by filing a whistleblower claim under the False Claims Act. In addition to helping the government hold unscrupulous companies accountable for their use of fraudulent practices, whistleblowers can also often recover compensation for their role in bringing the case to the public’s attention and for filing the claim on the government’s behalf. Typical rewards for successful claims range from between 15 and 30 percent of whatever the government recovers from the at-fault parties.

Do You Need Help Filing a Whistleblower Claim?

Filing a whistleblower claim can be both intimidating and complicated, making it especially important for those who have evidence of healthcare fraud, to speak with an experienced Florida healthcare fraud lawyer about their legal options. Please call Rabin Kammerer Johnson at 561-659-7878 today to learn more.