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Types of Whistleblower Cases

Medicare Fraud or Fraud in Health Care Billing

Common examples of medical fraud and fraudulent health care billing include, but are not limited to:

  • Off-label marketing of pharmaceuticals.
  • Upcoding of medical charges to a higher level of service or for more services than actually performed.
  • Violations of the Stark Self-Referral Laws.
  • Billing for services not performed or medical products not provided.
  • Double-billing.
  • Claims for health care for patients in exchange for “kickbacks.”
  • “Unbundling” of services required by Medicare rules to be “bundled.”
  • Allocating costs that should be borne by private insurers to a federal health program.
  • Billing for unallowable costs, and other costs that the federal health program doesn’t cover, such as lobbying, marketing and personal expenses. This conduct often will involve false statements concerning the true nature of the expenses.
  • Billing for unsafe or defective products sold in violation of FDA rules.

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BREAKING NEWS

01/10/2019 TAF Take: FY18 DOJ False Claims Act Statistics

Recently released fraud statistics from the Department of Justice do not leave whistleblowers, their attorneys, or good-government advocates with a particularly rosy picture of 2018.  Although the number of new qui tam cases fell only slightly — to 645 in 2018 from 680 in 2017 — the total value of recoveries in qui tam matters … Continue reading TAF Take: FY18 DOJ False Claims Act Statistics The post TAF Take: FY18 DOJ False Claims Act Statistics appeared first on Taxpayers Against Fraud Education Fund.…READ MORE

Source: TAF Education Fund Blog