The Department of Justice reported last September that it allegedly lost $1.4 billion in health care fraud schemes. Most of the recovered amount stems from criminal charges against doctors, nurses, and other licensed health service providers in the 31 federal districts across the United States.

Though the said amount might seem like it only affects healthcare professionals, it bears reminding that these health care fraud schemes affect us, people who rely on federal health programs, as well. 

These fraudulent activities not only undermine federal health programs like Medicare or Medicaid, but they also deprived us of receiving high-quality care from our health service provider.

So if you find out that you are a victim or know a victim of healthcare fraud, then it is your duty to report it to the authorities. Keep in mind that there are several laws that would protect you if you report and file a complaint against these fraudulent activities.

That said, here are the two steps or options you can take.

Report to the Authorities

Generally, you can directly call Medicare to report any suspicious activities.

These are their official hotlines:

• 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048
• Medicare Advantage Plan members can also report to this number 1-877-7SAFERX (1-877-772-3379)

Be sure to have all your details (such as Medicare number, provider’s name, specific date when the fraudulent activity happens, etc.) before making the call.

You can also submit a complaint to the Office of the Inspector General as well as the Federal Bureau of Investigation.  

In addition to these, you can all and report any fraudulent activities to your state’s authorities as well. Doing this might fast-track your complaints because there are other laws on health care that are only specific to certain states.

Through a simple search on Google, you can easily find your state’s official hotline to report health care fraud.

Go to Google.com and simply use the search string below

• report health care fraud STATE NAME site:.gov

See the picture for example

Get Help from a Legal Professional

As we have mentioned before, there are several laws that would protect you if you report any fraudulent activities related to health care. Laws such as the False Claims Act, Qui Tam Lawsuit, and others. On top of that, there are even provisions where you can receive rewards for reporting and pursuing these fraudulent activities.

However, successfully making the violators/abusers liable as well as getting these rewards can be a long, confusing, tedious process. You need to have a good grasp of the law (and even its nuances) in order to successfully do all these. So having a healthcare fraud lawyer to help you would not only make the process a lot easier but would also increase your chances of winning both the case and rewards.

But before you hire an attorney or legal professional, we encourage you to do a lot of research about them or their firm first. Doing this would ensure that you are hiring only the best lawyer for your case. Also, given that hiring a legal professional can sometimes be costly, asking around and doing a lot of research might even save you tons of legal and professional fees in the future.

Listed below are some of the things you should take note of when it comes to hiring an attorney

1.   Avoid Out-of-State Lawyer

Though there are tons of lawyers who passed several state bars, it is still best to hire a lawyer who resides in your state. This way, you can easily get in touch with them if you have any doubts or concerns.

2.   Experience Matters

You might have noticed that some law firms tend to have a specific practice area or expertise. This means that these lawyers are experienced and have handled several similar cases before. With that, you are rest assured that they can help you as well as protect you when you file a complaint. So it is best to hire a lawyer from a certain niche or those who have handled the same cases as yours.

Share the Burden

With all that said, you should immediately take action if you are or know a victim of health care fraud.

You would not only be making these violators/abusers liable, but you would also be doing a great public service for everyone.Letting these violators/abusers get away would decrease the quality and integrity of health care that we are all entitled to.

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