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Medicare Fraud Frequently Asked Questions
You must read the following notice before sending an e-mail message to Robins Kaplan LLP.
Any information that you send us in an e-mail message should not be confidential or otherwise privileged information. Sending us an e-mail message will not make you a client of Robins Kaplan LLP. We do not accept representation until we have had an opportunity to evaluate your matter, including but not limited to an ethical evaluation of whether we are in a conflict position to represent you. Accordingly, the information you provide to us in an e-mail should not be information for which you would have an expectation of confidentiality.
If you are interested in having us represent you, you should call us so we can determine whether the matter is one for which we are willing or able to accept professional responsibility. We will not make this determination by e-mail communication. The telephone numbers and addresses for our offices are listed on this page. We reserve the right to decline any representation. We may be required to decline representation if it would create a conflict of interest with our other clients.
By accepting these terms, you are confirming that you have read and understood this important notice.
What kinds of Medicare fraud cases can Robins Kaplan LLP handle?
Our firm handles a variety of matters involving fraud against Medicare and other federal healthcare programs. These include matters involving:
- Kickbacks
- Upcoding
- Clinical laboratories
- Unbundling
- Services that were never rendered
- Home healthcare
- A lack of medical necessity
- Improper physician self-referrals
What is a Medicare kickback violation?
The Anti-Kickback Statute (AKS) prohibits exchanging anything of value for referrals of services paid for by a federal healthcare program, including Medicare. Anyone who knowingly offers or receives a kickback can be liable under the AKS and, by extension, the False Claims Act.
What is upcoding in Medicare fraud, and how do I identify it?
Upcoding occurs when a healthcare provider submits an inaccurate bill to inflate the reimbursement it will receive. Typically, upcoded bills make use of service codes that are more complex or expensive than the services that the provider actually rendered. Upcoding can be a violation of the False Claims Act because it causes federal healthcare programs to pay more for services than they otherwise would.
What is Medicare home healthcare fraud?
Home healthcare presents many opportunities for fraud because the government pays for home healthcare based on information given to it by the treating providers. As a result, treating providers may have incentives to keep inadequate records or falsely certify a patient’s homebound status.
For a confidential case evaluation, please contact us at 1.888.563.1378 (toll-free), or complete our confidential case evaluation form above. We handle cases in all 50 states.
RELATED PROFESSIONALS
Timothy Q. Purdon
Partner
Co-Chair, American Indian Law and Policy Group;
Co-Chair, Government and Internal Investigations Group
Brendan V. Johnson
Partner
Co-Chair, American Indian Law and Policy Group;
Co-Chair, Government and Internal Investigations Group
If you are interested in having us represent you, you should call us so we can determine whether the matter is one for which we are willing or able to accept professional responsibility. We will not make this determination by e-mail communication. The telephone numbers and addresses for our offices are listed on this page. We reserve the right to decline any representation. We may be required to decline representation if it would create a conflict of interest with our other clients.
By accepting these terms, you are confirming that you have read and understood this important notice.