Hospital Administrator Whistleblower Lawyer Handles Hospital Administrator Whistleblower Medicare Fraud Lawsuits and Hospital Whistleblower Benefit Fraud Lawsuits by Hospital Administrator Whistleblower Lawyer and Hospital Whistleblower Benefit Fraud Lawyer

When corrupt Hospitals and Hospital Systems commit Medicare fraud, it is up to hospital administrators to expose the fraud. Whistleblower reward laws offer large financial rewards and whistleblower protections to hospital administrators who properly expose Medicare and Medicaid fraud.

If you are aware of a hospital or large health care company that is defrauding Medicare or Medicaid, it is important that you expose the fraud. Further, it can be helpful to have a lawyer confidentially review your potential case and discuss whistleblower reward laws and protections with you. For more information on this topic, contact Hospital Administrator Whistleblower Medicare Fraud Lawyer, Jason S. Coomer, via e-mail or contact us via our online submission form

Hospital Administrators Commonly Have Original Knowledge of Medicare Fraud Schemes and Medicaid Fraud Schemes That Can Pay Large Financial Rewards to Whistleblowers)

Hospital administrators run hospitals and commonly have specialized knowledge of business practices and billing practices. As such, they commonly know when fraud schemes are being committed. Benefit administrators, medical billing specialists, medical coding specialists, accountants, benefit specialists, facility coding supervisors, and other hospital administrator with original knowledge of fraud are encouraged to expose the fraud. One reason to expose the fraud is to claim large potential rewards that they can earn from exposing significant fraud. A second reason to expose the fraud is to avoid potential liability if the fraud is discovered or others expose the fraud.

Health care fraud costs United States tax payers large amounts of money through Medicare, Medicaid, and other government health care programs.  A critical aspect of the Health Care Fraud problem is that Medicare, the health program for the elderly and the disabled, automatically pays the vast majority of the bills it receives from companies that possess federally issued supplier numbers. Computer and audit systems now in place to detect problems generally focus on over billing and unorthodox medical treatment rather than other types of fraud schemes creating a need for Hospital Administrator Whistleblowers to expose these fraud schemes.

Healthcare Fraud is One of the Fastest Growing Crimes in the United States

Law enforcement authorities estimate that Medicare and Medicaid fraud costs taxpayers over $100 billion each year. For this reason the United States Government and several state governments have increased efforts to crack down on Medicaid Medicare fraud scams including upcoding, double billing, fraudulent medical billing, and illegal kickbacks. These efforts include massive efforts by law enforcement to arrest and prosecute those involved in fraudulent schemes.

Whistleblower Reward Laws Encourage Hospital Administrators to Expose Medicare Fraud Schemes and other Illegal Conduct

Further, the United States Government and several states have strengthed their whistleblower reward laws. Through these laws they encourage the public including hospital administrators to expose hard to detect fraud in the health care system. More specifically, they are targeting Hospital Billing & Upcoding Fraud, Hospice Fraud, Off-Label Marketing Fraud, and Medicare Fraud Schemes. Through these laws billions of dollars have been recovered from large corporations and other criminals who have committed health care fraud on the United States Government and State Governments. Further, over billion dollars have been paid to whistleblowers who have exposed fraud and other illegal schemes

There are several news stories regarding the government's crackdown on Medicare fraud. Many where fraudulent hospital administrators, hospitals, and health care providers have been caught committing health fraud and/or Medicare fraud.  For more stories on Medicare fraud crackdowns, please go to the United States Department of Justice press releases.

Massachusetts Hospital Agrees to Pay U.S. $2.79 Million to Resolve False Claims Act Allegations

WASHINGTON Mercy Hospital Inc. (d/b/a Mercy Medical Center) of Springfield, Mass., has agreed to pay the United States $2,799,462 to settle claims that it violated the False Claims Act between 2005 and 2006 by failing to provide, or failing to document that it provided, the minimum number of hours of rehabilitation therapy required under Medicare guidelines".

"Under Medicare, inpatient rehabilitation hospitals must provide a minimum amount of rehabilitative therapy to their patients. In June 2007, Mercy disclosed to the Department of Health and Human Services Office of Inspector General that it could not demonstrate that it had provided the required level of therapy. The settlement announced today resulted from the companys disclosure."

"This settlement demonstrates the Justice Department’s commitment to ensuring that Medicare patients get all of the care that Medicare pays for," said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. "As this settlement shows, those who come forward to disclose their violations and cooperate with the government will be dealt with fairly."

Hospital Administrator Whistleblowers Can Earn Large Financial Rewards Calculated by a Percentage of the Recovery Made By the Government

The False Claims Act was enacted to encourage private citizens including hospital coding & billing administrators, nuring home administrators, hospice providers, accountants, hospital managers, and other health care administrators to assist the government in the fight against fraud. Since the enactment of the False Claims Act, several amendments have been made to the act to encourage more whistleblowers as well as to protect whistleblowers from potential retribution.

The Act and Amendments allow a whistleblower to be awarded a percentage of any recovery made by the government based on the whistleblower's information. Further, the percent of this award can range from 10 to 30 percent depending on several factors regarding the how the claim is handled. In addition to the percentage, whistleblowers can also recover attorney's fees

Types of Claims Under the Federal False Claims Act

There are several types of Qui Tam claims covered under the False Claims Act:

  • Mischarging or overcharging for goods or services.

  • Improper price data and the request for payment for services never provided.

  • Holding government property for fraudulent purposes.

  • Avoiding payment of a debt to the government because of illegal reasons.

  • Knowingly providing the government with defective or dangerous products that were falsely certified.

  • Falsely certifying information for the entitlement of benefits.

  • Having any false claim paid by the government.

The mischarging case is the most common type of qui tam healthcare fraud case that is filed. Mischarging cases generally involve filing false claims for goods or services that were not provided or delivered.  A common mischarging scenario is where a health care provider submits charges for patients that never required these procedures or if the patient did not qualify for certain medical services such as Hospice.  Other common Qui Tam Healthcare Fraud Mischarging Schemes are claims made to the Government for medical services not rendered to a particular patient or for services performed by an attending physician when the service was actually performed by a nurse or other provider that should have been billed at a lower rate.

Originally, healthcare fraud was defined as deceptive means used by an organization to profit from government healthcare agreements. That definition has more recently been extended to include not only deception, but also unreasonable ignorance of the rules.

Healthcare fraud charges stem from the qui tam provision of the 1986 Federal False Claims Act, which allows citizens to file a suit on behalf of the federal government against anyone who has participated in government fraud. Many believe that one of the government’s primary motivations for passing this act was to uncover violations of healthcare contracts; indeed, healthcare fraud has accounted for more than half of all qui tam damages recovered since the act was passed.

Hospital Medicare Fraud Lawyers, Hospital Administrator Whistleblower Lawyers, Nursing Home Billing Fraud Lawyers, Health Care Fraud Kickback Lawyers, and Health Care Fraud Lawyers (Hospital Administrator Whistleblower Medicare Fraud Qui Tam Lawsuits)

It is extremely important that Hospital Administrator Whistleblowers continue to expose fraudulent billing practices and unnecessary treatments that cost billions of dollars.   If you are aware of Medical Billing Fraud, Medical Coding Fraud, or other Medicare Fraud that is being committed by a hospital, hospice provider, nursing home, a government contract, or other health care provider, feel free to contact Texas Federal False Claims Act Whistleblower Lawyer Jason Coomer.  As a Federal False Claims Act Whistle Blower Lawyer, he works with other powerful qui tam lawyers that handle large Medicare Fraud cases.  He works with San Antonio Qui Tam Lawyers, Houston Medicare Fraud Whistleblower Lawyers, California Healthcare Fraud Lawyers, Dallas Defense Contractor Fraud Lawyers, and other Texas Medicare Fraud Whistleblower Lawyers as well as with Medicaid and State False Claim Act Whistleblower Lawyers throughout the United States and the World to blow the whistle on fraud that hurts the United States and taxpayers. 

If you are aware of Medicare Fraud or other government fraud and are the original source with special knowledge of the fraud and want to be a whistleblower and an American Hero, please feel free to contact Federal False Claims Act Whistleblower Fraud Lawyer Jason Coomer via e-mail message or our submission form about a potential False Claim regarding a Health Care Fraud lawsuit, Medicare and Medicaid Fraud Lawsuit, Defense Contract Fraud Lawsuit, or other Government Fraud Lawsuits.


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