What is Medicaid Fraud?

Medicaid fraud encompasses a range of illegal activities, including:

• Billing for services not performed: Charging Medicaid for services that were never provided.
• False statements about eligibility or medical condition: Misrepresenting a patient’s eligibility or health status to receive payments.
• Providing unnecessary services or double billing: Performing unnecessary medical services or billing for the same service multiple times.
• Dispensing generic drugs but billing for name-brand drugs: Charging for more expensive name-brand drugs while providing cheaper generics.
• Receiving kickbacks: Giving or receiving something of value in exchange for performing services.

Example of Medicaid Fraud

Consider this case as an illustration of Medicaid fraud:

A licensed physician was involved in a conspiracy to defraud Medicare by falsely certifying that he had personally provided or supervised physical therapy services to patients of the Mirage Medical Group, operated by Tonya Williams and Kimberly Selders. To execute this fraud, Williams paid the physician in the fall of 1999 to sign patient charts, certifying that he had provided or supervised physical therapy services despite not having done so.

US v. Mauskar, 557 F. 3d 219 (5th Cir. 2009)

Conclusion

Medicaid fraud is a serious offense that impacts the integrity of healthcare and drains valuable resources. If you suspect or have evidence of Medicaid fraud, it’s crucial to take action. Our law office is committed to supporting whistleblowers through contingency representation, ensuring that you can report fraudulent activities without financial burden.

Contact us today for a free initial consultation and let us help you fight against Medicaid fraud.