Opportunities for Medicare Fraud Abound in Telemedicine; Qui Tam Whistleblowers Cases Will Likely Increase
During the Covid-19 pandemic, the number of Medicare fee-for-service (FFS) beneficiaries using telemedicine skyrocketed by 13,000%, according to CMS administrator Seema Verma. In fact, during a single three-month span in 2020, over 9 million Medicare FFS beneficiaries utilized some form of telehealth services.
While the opportunity for increased medical access afforded by telemedicine is great, the opportunity for abuse and fraud is equally prominent. In response, the Department of Justice (DOJ) has indicated that it intends to aggressively enforce Medicare compliance and hit telemedicine fraudsters where it hurts most: their pockets.
We at Price Armstrong expect the number of whistleblower cases involving telemedicine fraud to increase greatly, with the opportunities for whistleblowers to earn large monetary settlements to increase in direct proportion.
Preventing Telemedicine Fraud through the False Claims Act
While the DOJ can bring health care enforcement actions on its own against telemedicine fraudsters, it lacks the resources to investigate every allegation of health care fraud. This is where the False Claims Act (FCA) comes in.
The FCA allows whistleblowers to bring private qui tam actions involving allegations of Medicare and telemedicine fraud. In addition to providing protection from employer retaliation, the FCA rewards whistleblowers who successfully bring to light fraudulent practices with between 15% and 30% of the recovered sum.
So, in a qui tam case in which the government recovers $1 billion, the whistleblower could receive an award of $150 million.
With telemedicine Medicare fraud on course to expand even further, it is up to whistleblowers acting under the FCA to assist the U.S. government in putting an end to health care and telemedicine fraud.
At Price Armstrong, we have extensive experience litigating health care fraud cases under the False Claims Act. We work hard to both protect whistleblowers and maximize their recovery under the False Claims Act. Contact us today for a free initial consultation and review of your case.