Texas Medicare Fraud Lawyer Represents Medical Professionals Who Want to Expose Medicare Fraud Schemes and Earn Large Financial Rewards by Texas Medicare Fraud Lawyer Jason S. Coomer

Medicare fraud costs taxpayers billions of dollars each year. For this reason, whistleblower reward laws offer financial rewards to medical professionals who properly expose hard to detect medicare fraud. Most successful medical professional whistleblowers hire a lawyer to confidentially review their potential case. This confidential review protects the whistleblower during the process and improves the whistleblower's ability to claim a financial reward. If you are a medical professional who is aware of a significant Medicare fraud scheme, please consider exposing the fraud. Further, please feel free to contact Texas Medicare Fraud Lawyer and Texas Medicare Fraud Whistleblower Lawyer Jason Coomer via e-mail message or use our submission form to begin a confidential review of a potential claim.

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Medical Professionals Are Needed to Expose Hard to Detect Medicare Fraud Schemes

Healthcare fraud including Medicaid/Medicare Fraud costs the United States and Texas over one hundred and fifty billion dollars ($150,000,000,000.00) each year. For this reason, the United States government and several state governments have enacted whistleblower reward laws that target specific types of healthcare fraud. More specifically, many of these laws target Medicare fraud and Medicaid fraud. Further, these laws offer large financial rewards to medical professionals who properly expose hard to detect Medicare fraud schemes. Many of these whistleblower reward laws are complicated, but do allow medical professionals to earn large financial rewards for being the first to expose the fraud. Further, many of these laws also have built in whistleblower protections that protect medical professionals during the whistleblowing process. Understanding these laws and the whistleblowing process is essential to successfully exposing fraud and earning rewards as well as protecting the whistleblower.

These whistleblower reward laws are designed to expose significant fraud. To obtain a reward, the Medicare fraud typically needs to be well over a $1 million in Medicare fraud. Further, the information provided needs to be original information and not information obtained from public sources.

For more information on Texas Medicare Fraud Lawsuits, Texas Medicaid Fraud Lawsuits, and other Whistleblower Reward Laws, please feel free to contact Texas Medicare Fraud Lawyer Jason Coomer

There Are Many Types of Medicare Fraud Scheme That Can Be The Basis of Whistleblower Reward Lawsuits

The Government targets several different types of Medicare fraud schemes including upcoding, double billing, bill padding, unbundling, and charging for services never provided  Below are some additional types of Medicare fraud schemes:

  • billing Medicare for X-rays, blood tests and other procedures that were never performed

  • falsifying a patient’s diagnosis to justify unnecessary tests;

  • giving a patient a generic drug and billing for the name-brand version of the medication;

  • giving a recipient a motorized scooter and billing for an electric wheelchair, which can cost three times more;

  • billing Medicare for care not given;

  • billing Medicare for patients who have died or who are no longer eligible for Medicare;

  • billing Medicare for care given to patients who have transferred to another facility;

  • transporting Medicare patients by ambulance when it is not medically necessary;

  • requiring vendors to “kick back” part of the money they receive for rendering services to Medicare patients (kickbacks may also include vacations, merchandise, etc.);

  • billing patients for services already paid for by Medicare;

  • billing Medicare for phantom patients;

  • double billing Medicare for services;

  • upcoding services for increased Medicare payments.

In addition to the above Medicare fraud schemes there are numerous other types of hard to detect fraud schemes that may be the basis for whistleblower rewards. Medical professions who have original knowledge of these schemes are encouraged to expose these schemes.

Medical Professionals Often Have Specialized and Original Information Regarding Hard to Detect Medicare Fraud Schemes

Medical professionals because of their expertise often have specifialized knowledge regarding Medicare fraud schemes. This specialized knowledge is often referred to as "original information" and can be the basis for whistleblower reward. More specifically, most whistleblower reward laws require a whistleblower to have original information of the fraud they are exposing. The reason for this requirement is that the government is attempting to identify and regulate hard to detect fraud in the health care system through a bounty system to the public. Therefore, the government through these laws provides financial incentives or rewards to individuals with specialized knowledge of significan fraud.

Being the First to File on the Medicare Billing Fraud Scheme is Essential for Recovery Under the False Claims Act and can Prevent Potential Criminal Liability (Importance of Being the First to File on Texas Medicare Fraud)

Medical professional should also make sure that they do not delay in exposing Medicare fraud. A main reason for moving quickly in exposing Medicare fraud is most whistleblower reward laws have first to file requirements. For example the Federal False Claim Act only allows the first whistleblower to file to be eligible to recovery financial rewards. A second reason is that when the Medicare fraud scheme is exposed, the people who kept the fraud secret can sometimes be found liable for criminal activity for not exposing the fraud that was being committed and further be held liable for continuing criminal activity.

The Goverment is Cracking Down on Medicare and Medicaid Fraud

Texas and the Department of Justice are expanding Medicare Fraud Crackdowns and Texas Medicaid Fraud Crackdowns to expose and prosecute criminals that have been committing Medicare and Medicaid fraud. As such, it is very important for those who are aware of Medicare and Medicaid Fraud Schemes to come forward before the schemes are exposed and Health Care Executives start blaming each other and turning on each other to reduce their own potential criminal liability.

MEDICARE FRAUD STRIKE FORCE OPERATIONS EXPAND TO DALLAS AND CHARGE SEVEN IN NORTH TEXAS AREA WITH SCHEMES TO DEFRAUD MEDICARE OF $2.8 MILLION

North Texas Arrests Part of National Strike Force Takedown; 111 Defendant Charged with Submitting $225 Million in Fraudulent Claims

DALLAS — Seven North Texas-Dallas/Fort Worth, Texas-area residents, including the owners and operators of two health care companies, were arrested today on charges outlined in two indictments returned by a grand jury in Dallas last week and unsealed today, that they participated in a series of separate schemes in the North Texas area to defraud the Medicare program of more than $2.8 million, announced U.S. Attorney James T. Jacks of the Northern District of Texas, at a press conference in Dallas today. Mike Fields, Special Agent in Charge of the Dallas Regional Office of the Inspector General (OIG) for the Department of Health & Human Services (HHS), Robert E. Casey Jr., Special Agent in Charge, Dallas FBI Field Office, and the Texas Attorney General’s Medicaid Fraud Control Unit joined in making the announcement.

These indictments are part of a nationwide takedown by the Departments of Justice (DOJ) and HHS Medicare Fraud Strike Force, a multi-agency team of federal, state and local investigators designed to combat Medicare fraud through the use of Medicare data analysis techniques and an increased focus on community policing. These Medicare Fraud Strike Force operations have led to charges against 111 defendants for their alleged participation in Medicare fraud schemes involving more than $225 million in false billing. DOJ and HHS today announced that the Medicare Fraud Strike Force, previously operating in seven locations across the country (Miami, Los Angeles, Detroit, Houston, Brooklyn, Tampa and Baton Rouge), has expanded operations to Dallas and Chicago.

Texas Medicare Fraud Lawyers Help Medical Professionals Expose Medicare Fraud and Earn Whistleblower Financial Rewards

If you are a health care executive, hospital administrator, hospital compliance officer, coder, benefit coordinator, health care administrator, medical doctor, other health care professional, family of a Medicare or Medicaid recipient, or Medicare recipient with original source knowledge of Texas Medicare Fraud, Texas Medicaid Fraud, or other Medicare/Medicaid fraud, it is important that you are the first to step forward to blow the whistle on the Medicare fraud or Medicaid fraud.  If you are aware of Medicare Fraud or Medicaid fraud, feel free to contact Texas Medicare Fraud Whistleblower Lawyer Jason Coomer via e-mail message or our submission form

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