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Massive Medicare Fraud Sting Should Embolden Whistleblowers

By Greg T. Rinckey

Federal authorities upped the ante in their effort to curb Medicare fraud by carrying out Thursday the largest U.S. health care take down. The nine-city sting operation led by the Medicare Fraud Strike Force netted 111 doctors, nurses and others who allegedly illegally billed Medicare more than $225 million.

Charges against these medical professionals included billing Medicare hundreds of thousands of dollars for procedures that amounted to little more than toe clippings or back rubs or the removal of non-existent hemorrhoids. Over 700 law enforcement officials from various federal, state and local law enforcement agencies participated in the sting that indicted suspects in cities such as Miami, Dallas, Houston, Detroit, Chicago, Brooklyn, Tampa, Fla. and Baton Rouge, La.

This unprecedented sting reminds us how grossly the Medicare billing system is being abused by some in the medical profession. It should also serve as a reminder to others in the health care field who can blow the whistle on such fraudulent activities and benefit from whistleblower protections before a Medicare Fraud Strike Force team raids their own office.

Under the federal False Claims Act, non-government employees can take whistleblower actions and report the illegal billing activities of government contractors. For helping the government uncover false claims, whistleblowers stand to receive 15 to 25 percent of the recovered damages. Blowing the whistle on the fraudulent billing activities of a contractor – or even an employer – can seem like a daunting task. However, an experienced employment law attorney can work with the whistleblower to ensure that they receive federal protections for their activity.

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