What is Medicare Fraud?

Medicare fraud occurs when a hospital, nursing home, doctor's office, hospice care facility, ambulance service, pharmacy, rehabilitation center, or any other type of healthcare provider overbills Medicare.


Who can report Medicare fraud?

Medicare fraud whistleblowers are almost always healthcare professionals. They are commonly employed as hospital administrators, nurses, hospice or nursing home workers, ambulance drivers, pharmacists, or as any other type of healthcare professionals.

Receive a financial reward for your information.

Healthcare professionals may be entitled to a significant financial reward for becoming Medicare whistleblowers. Learn about receiving a financial reward for your information here.


Off label drug marketing fraud
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Prescription drugs are big business, very big business. The U.S. spent $300 billion in 2009 for 3.9 billion prescriptions. That equates to $1,000 per year for every man, woman and child in America.

Financial rewards for becoming a Medicare fraud whistleblower
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Recent changes to US whistleblower laws allow healthcare professionals to collect a significant financial reward (often millions of dollars) for reporting fraud against the government in the healthcare industry. US laws now allow individuals reporting Medicare fraud to receive full protection from retaliation and collect up to 30% of the fines that the government collects. The US government has paid out hundreds of millions of dollars to whistleblowers that come forward with information about healthcare fraud, with some individual whistleblowers receiving a reward worth tens of millions of dollars.

Who can become a Medicare fraud whistleblower?
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The False Claims Act is often touted as the most effective tool the government and its citizens have to recover monies stolen by fraudulent and false claims lodged by government suppliers.

Medicare: a system ripe for fraud
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By its very nature, Medicare is a sitting duck for fraudulent activity. Why? Because the government pays on an honor system, requiring only electronic submission to claim for services or goods provided by a health care provider.

Medicare Fraud statistics
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Consider this rogue’s gallery of data concerning Medicare fraud from a variety of government sources.

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