Billions and billions of dollars are spent every single year on the Medicare and Medicaid programs and because it is impossible to audit all submissions for payment, the programs are open to false statements and representations designed to secure money under false pretenses. Both programs are government funded but differ in eligibility and coverage. For example, Medicare is designed for people age 65 or older. However, people under the age of 65 may qualify if they have certain disabilities or suffer from End-Stage Renal Disease. Medicaid does not have the specific age limitations but is designed more for those with limited financial resources.
Medicare/Medicaid fraud takes a variety of forms and can cover anything from false claims and submissions for over treatment, to non-treatment, or any other scheme for which the purpose is to obtain money by means of false pretenses. Prosecutors are becoming increasingly aggressive in this area and are prosecuting physicians, healthcare providers, medical supply companies and other businesses when it can be established that false claims were submitted under the Medicare or Medicaid programs.
Our firm has an active whistleblower practice designed to help whistleblowers ferret out Medicare and Medicaid fraud. We not only defend Medicare and Medicaid fraud cases where appropriate, such as defending medical practices and physicians, but we also have represented whistleblowers who bring to the attention of the United States government schemes involving the Medicare and Medicaid programs.