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Monday, April 26, 2010

Hospital Whistleblowers and U.S. Department of Justice Recover Billions in Medicare Fraud

Hospital Administrator Whistleblowers Identify Medicare Fraud & Recover Money

Hospital Administrators including medical billing specialists, medical coding specialists, accountants, benefit specialists, facility coding supervisors, CEOs, vice presidents, and managers have been stepping up with doctors, nurses, and patients to blow the whistle on Medicare Fraud. These Hospital Administrators, Nursing Home Administrators, and Hospice Coordinators have been working with Medicare Fraud Qui Tam Lawyers and the United States Department of Justice to recover Billions of dollars in illegal kickbacks, medical double billing fraud, medical coding fraud, medical supplemental outlier payment fraud, and other forms of Medicare fraud. These hospital whistleblowers not only have been able to save United States Tax Payers Billions, but those that are the original source with special knowledge of the fraud and were first to file lawsuits on the fraud have been able to collect millions of dollars as a relator under the Federal False Claims Act.

Federal False Claims Act Amendments Encourage Medicare Fraud Recoveries

Recent Amendments to the Federal False Claims Act have not only increased protections for whistleblowers, but have also expanded the Federal False Claims Act to include subcontractors. By expanding the protections for whistleblowers and the potential liability for those committing Medicare fraud, the Federal Government is attempting to encourage more whistleblowers including hospital administrators to come forward and help fight Medicare fraud. The ultimate goal is to work with knowledgeable health care professionals to help reduce and recover more of the approximately $100 Billion in Medicare and Medicaid fraud that occurs each year.

In increasing the amount of potential Medicare fraud cases, the United States government had enacted an amendment to the Act that redefines "claim" to include claims submitted "to a contractor, grantee, or other recipient, if the money or property is to be spent or used on the Government's behalf or to advance a Government program or interest." This language makes explicit the ability of Government and whistleblowers to pursue subcontractors and grantees. This expansion will allow Hospital Administrators and other whistleblowers to potentially qualify as a relator and recover a portion of the recovered funds when turning in fraudulent health care providers and other businesses that contract with government programs.

Hospital Administrator Whistleblowers Have Specialized Knowledge

Because of the specialized knowledge that Hospital Network Administrators, Nursing Home Administrators, and other Health Care Professionals have regarding Medicare Coding, Outlier Payments, Medical Billing, Medicare Reimbursement, Medicaid Reimbursment, and Hospice Eligability, many are able to be the original source with special knowledge of fraud including Medicare Fraud, Tricare Fraud, VA Fraud, and Medicaid Fraud. This will allow many hospital administrators, nursing home administrators, and other health care professions that are the first to blow the whistle on Medicare Fraud, Medicaid Fraud, or other health care fraud to qualify as a relator and recover a portion of the recovered money.

For more information on Hospital Administrator Whistleblower Lawsuits, please feel free to go to the following web page, Hospital Administrator Whistleblower Medicare Fraud Lawsuits. This web page includes information on several recent lawsuits and settlements regarding Medicare and Health Care Fraud.

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