Healthcare Fraud & Healthcare Whistleblower Lawsuit News

http://www.lawyersandsettlements.com/lawsuit/healthcare-fraud.html#.VPO0d-FPrZX

Medicare is a government administered health insurance program for Americans aged 65 or older, or who are disabled. In addition to providing hospital and doctor expenses, it now provides options such as prescription drug coverage. Medicare fraud occurs when a person, company or organization intentionally submits Medicare reimbursement claims without having performed the duties being reimbursed, or having conducted medically unnecessary procedures for the purpose of billing the government.

Upcoding is a form of Medicare fraud that occurs when a healthcare provider uses the wrong code for a procedure to obtain a higher payment for work conducted. This is a violation of the False Claims Act.

Are repetitive ESI’s that does not produce positive outcomes or only produces positive outcomes for a very short time frame… or the physician requires pt to have ESI’s in order to get oral meds..

The insurance company that will not enforce the contract that those within their pharmacy network that decline to fill legit/on time/medically necessary Rxs.

There are probably laws being violated that will/could be considered healthcare fraud.. that we have not even consider yet !

Filed under: General Problems