Reporting Healthcare Fraud

The United States increased healthcare spending, from 2016-2017, by 3.9% reaching $3.5 trillion. In other words, $10,739 was spent per person for healthcare in 2017. The overall share o gross domestic product (GDP) related to healthcare spending was 17.9% in 2017. This is very similar to the 18% spent in 2016.

Medicare and Medicaid Spending

CMS reported that in 2017, Medicare spending grew 4.2% to $705.9 billion in 2017. This amounts to 20% of all healthcare spending. As to Medicaid total spending decelerated in 2017, increasing by 2.9% to $581.9 billion. Medicaid accounted for 17% of healthcare spending in the United States in 2017.

Healthcare Fraud

Based on these numbers and the amount of money spent on healthcare in the United States, it is not surprising that one of the biggest areas pursued by whistleblowers under qui tam statutes is healthcare fraud.

Options for Reporting Healthcare Fraud

There are several options to report fraud and you should consider the pros and cons of each. You can always report the healthcare fraud internally through a hotline, anonymously or to your supervisor. You can report the fraud directly to the government through various Medicaid and Medicare websites. You could also choose to file a False Claims Act case.

Reporting Healthcare Fraud Through the FCA

If you decide you want to report the fraud through a whistleblower statute, you should consult with a healthcare fraud attorney, specifically one familiar with the False Claims Acts. The experienced qui tam attorneys will work on a contingency fee basis (meaning, they will only get paid if the government recovers money) and will be able to evaluate your case, be able to walk you through the pros and cons of filing a qui tam case, and will know procedurally how to file a healthcare fraud case under the False Claims Act.

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