Doctors and Nurses Targeted for Medicare Fraud

Medical Professionals Face Prison Time for Failing to Report Medicare Fraud

U.S. Attorney General Loretta Lynch has continued her predecessor’s practice of targeting doctors, nurses, and other medical professionals for Medicare fraud.

This week 46 doctors, nurses, and other medical professionals were arrested for their involvement in schemes to submit false claims to Medicare.  The doctors and nurses are accused of providing false documentation for services that were not medically necessary or not actually provided to patients.

Medical professionals who work as employees of healthcare facilities are often under subtle pressure to increase revenues for their employers by providing services or extending treatments that are not medically necessary.  A physician feels pressure to order medically unnecessary diagnostic testing or pain medication injections.  A physical therapist feels pressure to authorize the maximum amount of therapy that can be reimbursed.  A nurse feels pressure to refer patients to a specific ambulance company or medical imaging center that has a financial arrangement with their employer.

It all seems very minor until law enforcement agents show up with handcuffs.  Then the doctor, nurse, or other medical professional has to deal with the fact that it is their signature, not their employer’s, on the medical records. 

Attorney General Lynch warned that we can expect more arrests of medical professionals.  "In the days ahead, the Department of Justice will continue our focus on preventing wrongdoing and prosecuting those whose criminal activity drives up medical costs and jeopardizes a system that our citizens trust with their lives," Lynch said.

Fortunately, the law helps medical professionals who report Medicare and Medicaid fraud.  Under the False Claims Act, an individual who helps the government uncover false claims to Medicare and Medicaid is entitled to a substantial reward and legal protections as a whistleblower.

If you have evidence that your employer is submitting false claims to Medicare or Medicaid, do not wait for government agents to show up at your home.  Consult with an experienced whistleblower lawyer immediately to protect yourself.  You may be entitled to a significant reward and legal protections.

To schedule a free and confidential consultation with an experienced whistleblower lawyer, call John Howley, Esq. at (212) 601-2728.