The Hippocratic Oath states that a physician will provide care to their patient, protect their patient’s privacy, and act ethically. Most physicians abide by that oath and ensure their patients receive the highest level of care.
However, some physicians and healthcare organizations don’t follow those same codes. Instead, they engage in unethical practices, such as committing Medicare fraud which costs taxpayers billions of dollars every year.
What is Medicare fraud?
Medicare fraud includes billing for services never provided, using false diagnoses to justify unnecessary tests or procedures, and charging excessive fees for covered services. In many cases, the people committing fraud are dishonest doctors, clinics, or other healthcare providers. The Federal Government considers Medicare fraud illegal, and engaging in fraud could result in penalties, fines, and time in prison.
If you suspect your employer is committing Medicare fraud, you can contact the Center for Medicare and Medicaid Services (CMS) or the Office of the Inspector General (OIG). As an employee, you are protected against retaliatory action from your employer by the Whistleblower Protection Act.
The New Mexico Fraud Against Taxpayers Act, also known as the New Mexico False Claims Act, allows whistleblowers to file a “qui tam” lawsuit against individuals or companies who have defrauded the government. If the suit is successful, the whistleblower may be eligible to receive a portion of the recovered funds. The Act imposes liability on individuals and companies who knowingly submit false or fraudulent claims for payment from the state government. It also provides incentives for whistleblowers to come forward by offering a portion of any recovered funds.
While the exact amount of fraud is difficult to determine, it is clear that it represents a significant drain on the Medicare program. It is crucial to crack down on fraud and prosecute those who engage in it to protect the program and ensure the efficient use of taxpayer dollars.