The Role of Whistleblowers in Healthcare
How Whistleblowers can Reform the Healthcare Industry
Whistleblowers have long been looked to by the U.S. government to help uncover wrongdoing and work with government agents to ensure that inside information about systematic fraud is revealed. The False Claims Act, which empowers whistleblowers to file lawsuits on behalf of the government, has been a powerful tool for preventing fraud and corruption since it was instituted during the Civil War. While the act was once mainly used against dishonest military contractors, these days qui tam actions are mainly filed by whistleblowers against healthcare providers.
Medicare, Nursing Homes, and Fraud
Since the rise of Medicare, the government spends about $1 trillion per year on providing medical care to its citizens. This money is generally in the form of reimbursements for medical costs, filed by hospitals, nursing homes, and pharmaceutical companies for care they provide to patients. Unfortunately, this vast sum of money too often represents a tantalizing source of revenue to healthcare providers that are looking to increase their profits. This has led to numerous examples of egregious fraud by facilities like skilled nursing homes, by caregivers, and by physicians. Our Contra Costa qui tam attorneys have seen many cases of healthcare providers trying to extract extra money from Medicare.
Sometimes this takes the form of outright lying, for example by claiming that more caretakers were present than actually were, or that they worked impossibly long hours for a patient. Sometimes it takes the form of charging the government for defective medical goods, or items which were not produced in accordance with government regulations. Perhaps the most pervasive form, however, is performing (and billing Medicare for) services that are unnecessary and don’t benefit the patient who receives them.
How Whistleblowers Help
As you’d expect, figuring out which bills contain fraudulent elements about the hundreds of thousands that Medicare receives is virtually impossible. Knowing which charges are unlikely or exaggerated is something that requires insider knowledge, and that’s something only whistleblowers can provide. By helping to hold healthcare providers to a high standard, whistleblowers not only ensure that patients are treated fairly, but also help Medicare keep costs down and ensure that future generations have access to the service.
If you or a loved one has knowledge of healthcare provider fraud in California, contact the Evans Law Firm whistleblower attorneys at (415) 441-8669, or by email at firstname.lastname@example.org. Our attorneys have experience with complex financial contracts and large insurance companies. We can help guide your case through a jury trial or toward an equitable settlement. We handle cases involving physical and financial elder abuse, qui tam and whistleblower law, nursing home abuse, whole life insurance and universal life insurance, and indexed, variable, and fixed annuities.