Prescribing Unnecessary Medications
Just a few decades ago, retail prescription drugs took up about 7% of the average American’s health care spending. Today, that figure is 12% and climbing. For people aged 65 and older and certain younger people with disabilities, Medicare Part D covers a large portion of those costs. In fact, Medicare spends well over $100 billion every year on prescription drug medications.
Unfortunately, such a huge program is vulnerable to fraud, and prescription drug fraud of Medicare occurs to the tune of up to $1 billion per year. Much of this fraud is committed by doctors prescribing medications to patients that they don’t really need, knowing Medicare will reimburse them for the cost.
Prescribing unnecessary medications is a particularly insidious form of health care fraud because it can cause real harm to patients. Taking medication you don’t need can hurt you, and you can also be exposed to side effects or interactions with other medications you are taking. Even if the fraudulent medication never makes it to you, it could wind up in your medical records and keep you from getting another medication you really do need because it would interact dangerously with the fraudulent prescription you are supposedly taking. But whether an unnecessary prescription causes physical harm to the patient or not, it causes very real financial harm to all taxpayers who have to bear this needless cost and an increased cost overall in health care.
If you work in a doctor’s office, hospital or clinic and become aware of a doctor prescribing unnecessary medications to defraud Medicare, Stacey Evans Law can help you blow the whistle to put an end to the fraud and also recover compensation as a reward for your efforts. Learn more about this dangerous form of health care fraud below, and call Stacey Evans Law for help blowing the whistle in Atlanta or Georgia statewide.
How Doctors Commit Health Care Fraud by Prescribing Unnecessary Medications
When dealing with Medicare patients, all Georgia physicians need to do to defraud Medicare is write up a prescription for a patient and turn in documentation to Medicare to cover the cost of the drug. The Centers for Medicare and Medicaid Services (CMS) reimburses the doctor, but the patient is most likely unaware the drug was ever ordered. Instead, the doctor intercepts the medication and disposes of it, or in some cases the physician might even sell the drug on the black market, depending on its popularity.
How Whistleblowers Can Be Compensated for Bringing This Health Care Fraud to Light
A whistleblower lawsuit is also known as a qui tam lawsuit, which is a legal phrase referring to a private individual bringing a lawsuit on behalf of the federal government. The federal law that allows you to do this is the False Claims Act (FCA), which was enacted specifically to encourage people to blow the whistle on government fraud.
Once you file a lawsuit alleging that a doctor has been prescribing unnecessary medications, the government has the option of taking over the case and going after the defendant itself. Whatever the government recovers, you get to keep 15 to 25 percent as a reward for bringing the matter to light. If the government doesn’t intervene, you can pursue the case yourself, and this time, you get to keep 25 to 30% of any monies recovered. The money damages in a Medicare fraud case can be quite large since the law makes the defendant liable for up to three times the amount of actual fraud.
Stacey Evans Law can help by representing you throughout the process. We’ll file the case on your behalf, and if the government declines to intervene, we’ll take the case on ourselves and work to hold the defrauding doctor accountable. Our firm has expertise in challenging and complex litigation so we’ll be ready to handle your case to a successful conclusion where you recover the maximum compensation available.
Stop Health Care Fraud in Atlanta and Georgia Statewide. Call Stacey Evans Law Today.
If you think you have uncovered Medicare fraud at your workplace in the form of a doctor prescribing unnecessary medications, reach out to an experienced health care fraud attorney who can advise, represent, and assist you in stopping the fraud while getting a reward for your efforts. In Atlanta or Georgia statewide, call Stacey Evans Law at 404-850-6750 to speak to a dedicated health care fraud lawyer.
