ATTORNEY NEWSLETTER

Department of Justice Watching Medicare Advantage Program

How Whistleblowers Help

The Department of Justice (DOJ) is taking a close look at government reimbursement of private insurers under Medicare’s Medicare Advantage Program. Medicare Advantage is a private insurer alternative to Parts A and B of the Medicare program for seniors. Medicare Advantage submits billions of dollars in claims every year to the government for reimbursement of medical expenses incurred by its subscribers. More and more, whistleblowers have revealed that many claims are invalid. We at Evans Law Firm have experienced whistleblower (also known as qui tam) lawyers who work with these cases every day. If you or a loved one has information regarding invalid or false claims under the Medicare or Medicaid programs, call the Evans Law Firm today at (415)441-8669 and we can help. California also has a False Claims Act for false claims against the State of California and our attorneys have vast experience with State cases as well.

The federal government investigates and prosecutes invalid claims for reimbursement under the federal False Claims Act (FCA). The FCA rewards whistleblowers whose information reveals fraud against governmental programs, such as Medicare and Medicaid. Sometimes the whistleblower information uncovers overcharging schemes on a huge scale. Recently, the DOJ joined in two whistleblower/qui tam suits against the country’s largest Medicare Advantage insurer alleging overbilling of more than $1 billion. The whistleblower’s information uncovered improperly coded patient diagnoses that resulted in huge payments for unnecessary medical services, many of which were never even rendered.

The whistleblower case led to an extensive review of reimbursements under Medicare Advantage. Last year in total the DOJ recovered more than $4.7 billion in settlements and judgments under the False Claims Act, many of which fell under the government’s Medicare and Medicaid programs. Over 700 whistleblower or qui tam suits were initiated during last year alone. The rewards for whistleblowers are big. In the past six years, the government has paid out some $3 billion to individual whistleblowers as awards for information. You should know, however, that whistleblower cases are lengthy and extremely complex. Experienced whistleblower attorneys at Evans Law Firm know what the government looks for in these cases and can effectively guide a case through investigation and trial toward government recovery and a bounty for the whistleblower.

Contact Us

If you have information regarding Medicare or Medicaid fraud including under the Medicare Advantage program and are looking to be a whistleblower in San Mateo County or in any California county, contact the Evans Law Firm elder attorneys at (415) 441-8669, or by email at info@evanslaw.com. Our attorneys have experience with complex qui tam or whistleblower cases, complex financial contract cases and cases against large insurance companies. We can help guide your case through a jury trial or toward an equitable settlement. We also handle cases involving physical and financial elder abuse, nursing home abuse, whole life insurance and universal life insurance, and indexed, variable, and fixed annuities.