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How to Report Medical Billing Fraud


Understand how to report medical billing fraud from the experienced healthcare fraud attorneys at Florin Gray. If you have a case, reach out to an attorney today.

Medical billing fraud ultimately hurts patients and costs U.S. taxpayers billions of dollars every year. Dishonest and unethical healthcare providers, insurers, and other related unscrupulous people must be brought to justice for their fraudulent medical billing practices. Through the qui tam provisions of the False Claims Act (FCA), an individual or group of people—working with an experienced whistleblower attorney—can file an FCA lawsuit reporting the fraud to the proper authorities who can stop it and recover any improperly paid funds.

An individual who brings a qui tam lawsuit is known as a relator and typically has inside knowledge of the wrongdoing. To effectively report medical billing fraud, relators will want to keep as much evidence of the fraud as possible. From emails, billing receipts, claims data, contracts, notes from conversations, and other special knowledge, a healthcare fraud attorney can assess the strength of your case and guide you on how to present it. And as a relator, you can receive up to 30% of the government’s total recovery in the case. With medical billing fraud, this can easily total millions of dollars.

Medical billing fraud often involves intentional misrepresentations or deceptions that result in the government paying a provider when it would not have paid had it known the truth. Abuse can involve unsound business or medical practices that drive up costs, and which make certain procedures medically unnecessary. Typical examples include billing Medicare or Medicaid for services that were not provided, overcharging for services that were provided, and ignoring critical regulatory requirements that a provider must comply with to seek payment. A healthcare fraud attorney will evaluate the unique facts of your case and plan how best to report the medical billing fraud to the appropriate authorities. Whistleblower attorneys will help you at every step of the process and protect you from retaliation in the workplace.

The whistleblower attorneys at Florin Gray have more than five decades of experience in cases involving the FCA. They are known for their solid legal strategies that help individuals and the government maximize recoveries and stop the wrongdoing. Contact the team at (727) 220-4000 or by emailing [email protected] when you learn of fraudulent billing, improper coding of claims, manipulative charges or reimbursements, kickbacks or bribes, or other facts that violate ethical standards in healthcare.

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