Taking the first steps to report Medicaid fraud at your workplace, or as a patient, can feel overwhelming, but rest assured, you are doing the right thing. Government waste increases the price of healthcare, affecting those who can ill afford to pay more, or pay on their own. If your fraud complaint is successful, you may be eligible for a portion of any money the federal government recovers. Our Hempfield Township, PA Medicaid whistleblower lawyer can help you file the initial complaint, protect your identity as long as possible, and secure your share of the recovered funds. Call the Law Offices of Darth M. Newman to learn more.
Medicaid Whistleblower Lawyer, Hempfield Township, PA
Whistleblowers are protected by federal law when they initially file their qui tam lawsuits to report Medicaid fraud. Fraud can take many forms, including overbilling, charging for more expensive services than the patient received, or charging for “ghost” patients. As experienced Hempfield Township Medicaid whistleblower lawyers, we’ve seen some pretty creative forms of Medicaid fraud.
Ultimately, the people the fraud affects most are the ones who can least afford it. Patients may not continue to receive coverage if wasted funds cause the government to cut Medicaid funding. And, patients whose charts show certain procedures were performed, when they actually weren’t, or whose charts show certain medications or medical devices are used (when they aren’t), may end up with a lot of problems if they see a new provider.
Under the federal False Claims Act (FCA), whistleblowers like you file the initial complaint, and the government conducts an investigation. If we ultimately recover funds for the government, you are entitled to between 15% and 30% of those proceeds.
Our firm helps you report the fraud to the correct authorities under the shield of the FCA. We help you properly gather evidence supporting your allegations and protect you throughout the legal process. If your employer tries to retaliate against you, we can address that by initiating legal action against them. We’re on your side, and we’ll help you do the right thing.
Why Experience Matters For Medicaid Fraud Claims
Medicaid fraud claims involve complex legal matters and require a thorough knowledge of both Medicaid billing protocols and federal fraud laws. Our experienced Hempfield Township Medicaid whistleblower lawyer has the experience and resources necessary to properly draft, file, and litigate your complaint.
- Firm founder Darth M. Newman was named to the Top 100 Trial Lawyers List
- Darth is an active member of the TAF Anti-Fraud Coalition, a public interest non-profit organization dedicated to fighting fraud against the government
- We’re very involved in the local community as a proud member of the Pittsburgh Airport Area Chamber of Commerce
- Darth serves as a pro bono mediator for the EEOC and the Pittsburgh Commission on Human Relations
Do you suspect Medicaid fraud and need help reporting it? We want to hear your story. Call the Law Offices of Darth M. Newman today for a consultation.
Types Of Medicaid Whistleblower Cases Our Firm Handles
Medicaid whistleblower cases play an important role in uncovering fraud and protecting public funds, as our Hempfield, PA Medicaid whistleblower lawyer knows. When healthcare providers or organizations misuse Medicaid dollars, it can lead to waste and harm to patients. If you have firsthand knowledge of wrongdoing, you have the right to report it and may be entitled to financial compensation through a whistleblower claim. Our firm was established 5 years ago, but attorney Darth Newman has been practicing law for 17 years. Trust him to take care of your Medicaid whistleblower needs.
False Billing Practices
False billing occurs when a provider submits claims for services that were never performed or exaggerates the level of care provided. This type of misconduct drains public resources and inflates healthcare costs. You can bring attention to this behavior by reporting false claims and helping prevent future fraud.
Upcoding And Unbundling
Our Hempfield Medicaid whistleblower lawyer can tell you that upcoding involves billing for a more expensive procedure than the one actually performed. Unbundling happens when a provider separates related procedures into multiple claims to increase reimbursement. These billing tactics are deliberate acts that violate Medicaid rules and often lead to significant overpayments.
Kickback Schemes
Kickback schemes involve illegal payments or incentives given in exchange for patient referrals or the use of specific services, drugs, or medical devices. These arrangements can interfere with medical judgment and compromise patient care. Reporting such conduct helps maintain fairness and transparency in the healthcare system.
Phantom Employee Fraud
Some organizations bill Medicaid for salaries or services tied to employees who do not exist or who did not perform the claimed work. This kind of false reporting is intentional and designed to divert public funds. Whistleblowers play a crucial role in uncovering and stopping this misuse of Medicaid resources.
Prescription Drug Fraud
Prescription fraud includes practices such as billing for medications not provided, altering prescriptions, or dispensing unnecessary drugs to increase profits. These actions contribute to rising healthcare costs and can endanger patient safety. Your information could help stop unlawful behavior and recover funds for the Medicaid program.
Cost Report Misrepresentation
Hospitals, nursing homes, and other providers submit cost reports to determine reimbursement rates. Fraud occurs when these reports are inflated with false expenses, personal costs, or unrelated business charges. By coming forward with evidence, you help protect taxpayer money and restore accountability to the healthcare system.
Durable Medical Equipment Fraud
Durable medical equipment (DME) fraud includes billing for equipment that was never delivered, charging for items not medically necessary, or using patient information without consent to submit claims. This type of fraud is common and costly. Reporting it helps prevent ongoing abuse and promotes fair use of Medicaid resources.
Managed Care Organization Fraud
Managed care organizations that administer Medicaid funds can also engage in fraud by falsifying patient data, manipulating claims, or misusing federal reimbursements. These cases often involve large-scale violations that affect thousands of beneficiaries. Your decision to report such conduct can have a lasting positive impact on the integrity of the program.
At the Law Offices of Darth M. Newman, we help individuals who choose to report Medicaid fraud understand their rights and pursue legitimate whistleblower claims. Our team is committed to protecting those who come forward and holding organizations accountable for the misuse of public funds. With numerous 5 star reviews on Google Reviews, you can count on our firm to handle your whistleblower case. If you suspect fraudulent activity within the Medicaid system, contact our Hempfield Medicaid whistleblower lawyer today to discuss your situation and take the first step toward stopping the wrongdoing.
