Types of False Claims One Can Make and How Lawyers Help

,also known as Lincoln Law, holds person or companies liable to irregularities or frauds against the government. Under this law, private citizens can file a lawsuit against individuals and businesses on the behalf of the federal government.

The law came into existence during the Civil War. Now days, under this law, whistleblower lawsuits are filed and whistleblowers, if allegations is proved true, can receive compensation.
The most common types of False Claims that one can make are: 

• False Certification Claims

These claims occur when a person or entity knowingly submits forged and fraudulent claim to get payment from the government. Under this claim, the most common example is of a doctor where he or she submits an inflated bill or fake bill to the government for services provided under Medicare.

• Mischarge and Overcharge Claims

These claims occur when a person or entity knowingly submits forged and fraudulent claim to get payment from the government. Under this claim, the most common example is of a doctor where he or she submits aninflated bill or fake bill to the government for services provided under Medicare.

• Conspiracy Claims

It occurs when individual or companies work in tandem to violate the False Claims Act. The conspiracy claim usually occurs when a general contractor knows that subcontractors, it has employed, are violating terms set under federal contract. In such cases, both types of contractors are liable for conspiracy.

• Reverse False Claims

In such claims, individuals or businesses knowingly conceals or withhold information from the government about the overpayment it had been receiving. A typical reverse false claim involve a hospital that has been obtaining Medicare payments, which sometimes can result into overpayment, and to avoid refund to the government, it presents a forged cost report.

The role of lawyers

The False Claims Act has many complex rules, which are incomprehensible to untrained minds. It is necessary that you hire a false claims act attorney before filing a complaint.

Moreover, a disclosure statement is required to be submitted to the Justice Department, confidentially. An improperly drafted disclosure statement can lead to dismissal of the complaint.

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How to spot and stop healthcare fraud?

Trillions of dollars are released for various health and medicare schemes every year. These schemes primarily include health insurance and various plans under which government aids the needy through discounted/free healthcare facilities. The most common instance of healthcare fraud is falsified insurance claim. Another type of healthcare fraud is practiced by service providers, as hospitals, doctors, physicians, chemists, and pharma and insurance companies. They provide unjust treatment/services to patients and medicare beneficiaries.

How to Spot These Frauds?

• Before enrolling for a health insurance scheme, read through all the T&C, and speak to the agent/representative of the company to understand the scheme.
• Be aware of policies and regulations set by state authorities and federal government. 
• Check if the policy that you are registering for is government approved. (However, this could be a tricky task. So, you can consider checking the reviews of the insurance program on the internet.)
• Stay attentive when seeing your doctor/hospital.
• Make sure you are getting the right treatments/tests.
• Take invoice for all your treatments/tests/medications.

Keeping these points in your consideration will help you spot the irregularities in the healthcare sector.

How to Stop Healthcare Fraud?

• Once you notice some irregularity, you can consult to a CMS lawyer.
• Discuss your concern with the attorney, and understand if your case is really a case of healthcare fraud.
• Register your complaint and file the case with the help of your False Claims Act attorney.
• False Claims Act is a litigation tool, presented by the federal government that enables you to sue the fraudster on behalf of the government. 

If your charges are proved, you will receive the compensation (certain percentage of recovered money) from the government. Your False Claims Act lawyer will help throughout the proceedings until the responsible are held and fined. These lawyers help you stop of the instances of fraud in the healthcare sector.

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