Do You Know of a Company Committing Homecare or Hospice Fraud in Medicaid Billing?
State False Claims Acts are violated when a Medical homecare or hospice provider submits claims to Medicaid for care provided by uncertified or unlicensed caregivers, falsified records, fake eligibility schemes, or billing for higher levels of care than provided or services not provided or inadequate services.
People who report Medicaid fraud may be eligible for a substantial cash award under their State’s whistleblower laws.
Common Homecare or Hospice Schemes the Violate Medicaid False Claims Laws
If you have information regarding a violation of your state’s False Claims Act through fraudulent Medicaid billing practices, you may be entitled to a large cash award for reporting fraud. Typical homecare or hospice fraud schemes that Medical providers use to defraud state Medicaid programs include:
- Licensing or certification violations: Providing medical care without the required certification or licensing.
- Falsified documents: Misrepresenting diagnoses or symptoms, altering dates or times, forging signatures, or signing regulated documents by unlicensed nurses or staff.
- Billing for services not provided: Billing Medicaid for products or services, such as treatments, laboratory work, diagnostic tests, x-rays, medical devices or pharmaceuticals, when the patient never actually received the product or service.
- Billing for medically unnecessary services: Billing for diagnostic procedures, treatment protocols, pharmaceuticals, or medical equipment that is not medically necessary for the recipient (often via false diagnosis or symptom reports).
- Overbilling: Billing for more expensive services than the service actually rendered. Billing for advanced life support services while supplying only basic life support services.
- Billing for ineligible patients: Submitting claims to Medicaid for patients who are ineligible for Medicaid coverage, whose Medicaid coverage has expired, or who are deceased. May involve Medicaid ID theft.
- Anti-kickback violations: Providing discounts or gifts to medical institutions or medical providers in exchange for patient referrals.
You Might be Entitled to a Cash Reward for Reporting Homecare or Hospice Medicaid Fraud
Your state’s False Claims Act has a whistleblower provision that pays cash awards of fifteen to thirty percent of any money the state recovers to tipsters who were the first to report the fraud with insider information sufficient to establish a Medicaid homecare or hospice fraud case.
Every State False Claims Act protects people who blow the whistle on fraud: it is illegal to fire or demote any employee who reports Medicaid fraud. Damages can be substantial and are in addition to any money you might be entitled to as a whistleblower reward.