Medicare and Medicaid fraud cost the federal government billions of dollars. The deception and dishonesty of some healthcare providers cause a significant amount of fraud each year.
A Chicago Medicare fraud attorney with Horwitz, Horwitz & Associates can help sort through this fraud and deception. If you would like more information on how we can help, please schedule a free consultation by calling (800) 985-1819 or contacting us online. You won’t find a team of Chicago personal injury attorneys who will work harder on your behalf.
Our Medicare fraud services we provide
At Horwitz, Horwitz & Associates, our Chicago Medicare fraud attorneys have extensive experience in this area of the law. These are just a few of the essential service offerings we provide.
Assistance with audits and investigations
We assist clients in navigating audits and investigations related to Medicare fraud, offering guidance on compliance, gathering evidence, and crafting strategic approaches to ensure the best possible outcome.
Development of compliance programs
Our team also has extensive experience developing tailored compliance programs that help healthcare providers and organizations adhere to Medicare regulations. This not only helps them mitigate the risk of fraud but also helps ensure they adhere to regulatory and statutory requirements.
Advising on regulatory and statutory requirements
We provide expert advice on the numerous complex rules and laws associated with Medicare. Our team of legal experts goes to great lengths to ensure our clients understand and comply with the laws and regulations governing operations.
Negotiation with government agencies and insurers
Horwitz, Horwitz & Associates lawyers leverage our experience and negotiation skills to engage with government agencies and insurers on behalf of our clients. We do this to achieve favorable resolutions and minimize potential penalties or liabilities.
Advocacy in administrative hearings and appeals
Our Chicago Medicare fraud attorneys advocate for clients in administrative hearings and appeals, presenting compelling arguments and leveraging our knowledge of the law to protect our client’s rights and interests.
Assistance with self-disclosure and repayment
We also help our clients navigate the complexities of reporting and rectifying potential Medicare fraud. This helps minimize potential penalties and other legal consequences as a result.
Common types of Medicare fraud
Our law firm has been around since 1924. We’ve seen many different types of Medicare fraud, and we have a deep understanding of them. The following is a brief look at some of the most common examples.
Billing for services not provided
This type of Medicare fraud involves submitting claims for medical services never rendered to patients. Fraudsters deceive the system by fabricating records and invoices, leading to improper payments and significant financial losses.
Upcoding
Upcoding occurs when healthcare providers intentionally assign higher billing codes to services they provide, making them appear more complex or extensive than they are. This fraudulent practice aims to increase reimbursement rates, resulting in inflated costs for Medicare and potential harm to patients.
Unbundling
Unbundling refers to the fraudulent practice of billing separately for individual components of a medical procedure that should be billed as a single service. By unbundling, providers exploit higher reimbursement rates for each separate detail, leading to excessive payments and financial losses for Medicare.
Kickbacks
Kickbacks involve illegal financial arrangements where healthcare providers receive payments or rewards in exchange for patient referrals or the use of specific medical services or products. These kickbacks corrupt the decision-making process, compromise patient care, and inflate healthcare costs.
Phantom billing
Phantom billing occurs when healthcare providers submit fraudulent claims for services or procedures that never took place. This type of fraud involves fictitious patient information or fabricated documentation, resulting in improper payments and financial losses for the Medicare program.
False diagnoses
This fraudulent practice involves healthcare providers deliberately misrepresenting or inventing medical conditions to justify unnecessary procedures or treatments. By providing false diagnoses, fraudsters exploit Medicare by submitting claims for services that are not medically necessary, leading to wasted resources and potential harm to patients.
Identity theft
Identity theft in the context of Medicare fraud involves the unauthorized use of someone’s personal information to fraudulently obtain medical services or prescription drugs. Fraudsters may steal Medicare beneficiary information, leading to improper billing and potential harm to the victims whose identities are compromised.
Double billing
Double billing occurs when healthcare providers submit multiple claims for the same service to Medicare or bill the patient and Medicare for the same service. This fraudulent practice results in excessive reimbursement and financial losses for the Medicare program.
Prescription drug fraud
This type of fraud involves various schemes, such as forging prescriptions, obtaining medications through false identities, or selling counterfeit drugs. Fraudsters exploit Medicare by fraudulently obtaining prescription drugs and billing the program, leading to steep monetary losses and potential risks to patient safety.
What is a whistleblower lawsuit?
The Federal Civil False Claims Act (31. U.S.C., Section 3729) states that private citizens can act on behalf of the federal or state government to bring an action against a person or company that acts fraudulently. Under the False Claims Act, a qui tam (whistleblower) lawsuit allows individuals employed by the entity guilty of fraud to bring a lawsuit for fraud-related damages against the offending company.
What steps should I take if I know the government is being defrauded?
If you know the government is being defrauded, you may have the right to financial compensation. There is a strong incentive for those who witness fraudulent acts against the federal government to come forward.
If you witnessed fraudulent acts against the government, you have the right to recover between 15-30% of the total amount recovered from the lawsuit. Please keep the following in mind when you decide to take action against fraudulent behavior.
Gather information
Collect as much evidence and documentation as possible related to government fraud, including contracts, invoices, emails, or any other relevant information that can support your claim.
Contact a Chicago Medicare fraud attorney
Seek the advice of an experienced Chicago Medicare fraud attorney who specializes in whistleblower cases to understand your rights, legal options, and the best course of action to take.
File a whistleblower complaint
Follow the appropriate procedures to file a complaint with the relevant government agency or through the False Claims Act, providing detailed information about the fraudulent activities and supporting evidence.
Protect yourself
Safeguard your interests by keeping your involvement confidential, documenting any retaliation or adverse actions, and following legal advice to ensure your rights and protection throughout the process.
Follow-up
Stay engaged with the investigation or legal proceedings. You should maintain regular communication with your attorney and relevant authorities, provide additional information or support as needed, and follow through until a resolution is reached.
Benefits of working with a Chicago Medicare fraud lawyer
Hiring a Chicago Medicare fraud lawyer offers numerous advantages. A skilled lawyer with Horwitz, Horwitz & Associates will possess specialized expertise in healthcare fraud laws, ensuring a thorough understanding of the complexities involved.
They’ll also provide strategic guidance throughout the legal process, maximizing the chances of a favorable outcome. Our effective representation in court will protect your interests and rights, while our knowledge of the intricacies of Medicare fraud cases will strengthen your case.
Why hire Horwitz, Horwitz & Associates?
When you choose a Chicago Medicare fraud attorney with Horwitz, Horwitz & Associates, you’ll work with a legal expert with a proven track record of success in advocating for clients and achieving justice.
Our team includes highly skilled lawyers with in-depth knowledge of Medicare regulations and fraud investigation procedures. By choosing Horwitz, Horwitz & Associates, you’ll gain a trusted partner committed to providing exceptional legal representation and dedicated to securing the best possible results in Medicare fraud cases.
Our Chicago Medicare fraud attorneys are ready to help
If you suspect a person or entity involved in defrauding the government, we invite you for a free consultation. You may discuss the incidents and ask any questions you may have with one of our Chicago Medicare fraud attorneys.
Our Chicago whistleblower lawyers have more than 30 years of experience. We have an outstanding track record in helping our clients and creating a strong trust relationship, as seen in our Success Record. Please call our toll-free number at (800) 985-1819.
