Can an ordinary employee expose fraud by a large healthcare company and make a difference?
YES THEY CAN.
Settlements and Verdicts
Whistleblower and False Claims Act Litigation
Exposing Healthcare Fraud and Protecting Taxpayer Dollars
At Marino Associates, we represent whistleblowers who possess information concerning healthcare fraud, Medicare fraud, Medicaid fraud, and violations of the Federal False Claims Act.
A Multi-Million Dollar Recovery in Hospice Fraud Litigation
Our firm represented a whistleblower in a federal False Claims Act case involving allegations that hospice providers improperly billed Medicare for services that were not eligible for reimbursement. The allegations resulted in a federal investigation and ultimately a multi-million dollar settlement resolving claims asserted on behalf of the United States.
The case illustrates the vital role whistleblowers play in uncovering fraud that might otherwise go undetected. Individuals working inside healthcare organizations are often the first to recognize irregular billing practices, improper patient admissions, falsified medical records, or conduct designed to maximize reimbursement at the expense of patients and taxpayers.
Through the federal False Claims Act, whistleblowers may file what is known as a “qui tam” action on behalf of the United States. These lawsuits are initially filed under seal while the government investigates the allegations. If the action results in a recovery, the whistleblower may be entitled to receive a percentage of the funds recovered by the government.
Fraud against Medicare and other government healthcare programs costs taxpayers billions of dollars every year. In many cases, the fraud remains hidden until a courageous employee, manager, healthcare professional, or insider comes forward with information about unlawful billing practices, kickbacks, falsified records, or other schemes designed to obtain government funds improperly.
What Is a False Claims Act Case?
The Federal False Claims Act is one of the government’s most powerful tools for combating fraud involving taxpayer-funded programs. The statute allows private citizens with knowledge of fraud to bring lawsuits on behalf of the United States and share in any recovery obtained from the wrongdoers. Whistleblower actions have resulted in billions of dollars being returned to federal healthcare programs.
False Claims Act cases frequently involve:
- Medicare fraud
- Medicaid fraud
- Hospice fraud
- Hospital billing fraud
- Upcoding and improper reimbursement practices
- Kickback schemes
- Pharmaceutical fraud
- Home healthcare fraud
- Durable medical equipment fraud
- Government contractor fraud
Common Signs of Healthcare Fraud
Employees should be alert to practices such as:
- Billing for services never performed
- Billing for medically unnecessary services
- Altering patient records
- Falsifying diagnoses to obtain reimbursement
- Paying or receiving illegal kickbacks
- Admitting patients who do not qualify for services
- Misrepresenting the level of care provided
Protecting Whistleblowers Throughout Pennsylvania and New Jersey
If you possess information that a healthcare provider, hospice, hospital, pharmaceutical company, government contractor, or other organization is submitting false claims to the government, you may have legal rights under the Federal False Claims Act and related whistleblower statutes.
Marino Associates assists whistleblowers in evaluating potential claims, preserving evidence, navigating federal investigations, and pursuing recoveries under state and federal whistleblower laws.
If you believe you have information concerning healthcare fraud or government fraud, contact Marino Associates for a confidential consultation.
Many whistleblowers are concerned about retaliation, termination, or professional consequences. Federal law contains protections designed to safeguard individuals who report fraud and cooperate with government investigations.
