Spotting Medicare And Medicaid fraud

Medicare defines fraud as "making false statements or representations of material facts in order to obtain some benefit or payment for which no entitlement would otherwise exist." In order to prove fraud has been committed against the government, it is necessary to prove fraudulent acts were performed knowingly, willfully and intentionally.

If you suspect something, say something. Call The Law Firm of Jacobson & Rooks, LLC, in Philadelphia, Pennsylvania, first at 856-208-5748 and speak with our attorneys.

Medicare And Medicaid Billing Fraud

Much of the Medicare and Medicaid fraud occurs in the context of billing. People who work in the billing departments of organizations that submit claims to Medicare and Medicaid are usually in the best position to identify fraud. The government's payment for all claims submitted to Medicare/Medicaid is conditioned upon the health care provider's compliance with Medicare/Medicaid regulations. The False Claims Act sets forth the framework that must be followed to report fraud and authorizes payment to the person who does so.

Government-funded health care plans aren't just Medicare and Medicaid. One government-funded health insurance that may be overlooked is TRICARE. TRICARE is the health care program for uniformed military service members and their families. TRICARE covers all active and retired persons from the branches of U.S. military, including the National Guard and Reserves. TRICARE is managed by the Defense Health Agency under leadership of the Assistant Secretary of Defense (Health Affairs). TRICARE is a major part of the Military Health System that combines the resources of military hospitals and clinics with civilian health care networks. Fraud under the TRICARE program is fraud against the government, just as it is under Medicare and Medicaid.

Contact Us First And Speak With A Knowledgeable Lawyer

People and corporations that commit fraud try to conceal their fraudulent activities. Fraud is not always easy to detect. Did you ever see something and think, "That should be against the law?" Maybe it is.

If You Suspect Something, Say Something To Us First. Call 856-208-5748 or contact us online.