Whistleblowers and Healthcare Fraud

Healthcare fraud can occur at many levels in the healthcare system. Some of the areas where fraud is found are listed below.

Pharmaceutical Fraud
Some of the most common types or pharmaceutical fraud include:

• paying kickbacks or providing incentives to prescribers to prescribe drugs
• marketing drugs for unapproved uses
• false reporting to Medicare and Medicaid
  Read more about pharmaceutical fraud
  

Medical Device Durable Medical Equipment (DME) Fraud
Some of the most common types or medical device fraud include:

• paying kickbacks or bribes/incentives to providers to use a product
• marketing devices for for uses that have not been approved by the FDA
• knowingly selling defective devices
• billing Medicare for unnecessary medical devices
  Read more about medical device/DME fraud
  

Clinical Laboratory Fraud
Some of the most common types or pharmaceutical fraud include:

• paying kickbacks or incentives to providers to refer patients to a lab

• paying kickbacks or incentives to providers to prescribe unnecessary tests

• performing tests that were not ordered by a physician

• billing Medicare/Medicaid for tests that were not performed
  Read more about clinical laboratory fraud
  

False Claims Act
The False Claims Act (FCA), also known as the "Lincoln Law," is a crucial federal law enacted in the United States to combat fraud against the government. While not all fraud in the healthcare industry will fall under the FCA, many types of healthcare fraud do include violations of the statute. The FCA encourages individuals with knowledge of false claims made against the government to come forward and file lawsuits, known as qui tam actions, on behalf of the government. Read more about the False Claims Act here.