Health Care Law

Check the Medicare website if you suspect violation of healthcare laws The official website for Medicare has a section on fraud with clues that health care laws are being violated. The website also explains how the suspected fraud should be reported.

I recommend:  The full list on the Medicare website should be reviewed. Suspicious actions are representations that the equipment or service is free and not charging co-payments without checking on your ability to pay. Charging co-payments on Medicare covered preventive services, such as PAP smears and prostate specific antigen (PSA) tests, is also suspicious. A guide to preventive services can be downloaded from the Medicare website.

Check the Centers for Medicare and Medicaid Services (CMS) for information on healthcare law fraud The CMS administers Medicare and Medicaid and issues a Medicare Summary Notice (MSN) to beneficiaries. The MSN lists the health insurance claims made for the beneficiary on a quarterly basis.

I recommend:  Read the instructions for reviewing MSNs on the Medicare website. CMS supplies a list of publications that can be downloaded about fraud prevention. You should compare your MSN billing statement with your own records and look for charges for something you didn’t get, billing for the same thing twice and services that were not ordered by your doctor.

Seek out health care attorneys at the Qui Tam Online Network if needed This organization's website is supported by healthcare lawyers and environmental lawyers interested in representing plaintiffs (also called relators) in False Claims Act lawsuits.

I recommend:  The Qui Tam Online Network contains a considerable amount of information about whistle-blower or qui tam lawsuits. One of the major law firms in this area is Phillips & Cohen LLP. This law firm claims to have recovered over $2 billion dollars from whistle-blower actions.

Learn about State False Claims Acts and how they relate to healthcare law Many states have enacted false claims acts to help uncover fraud in Medicaid.

I recommend:  The website of the Office of Inspector General of the U. S. Department of Health & Human Services has a review of the false claims acts by state. The False Claims Act Center Legal Center has a considerable amount of information on this topic.