What is the False Claims Act?

The False Claims Act is a federal law that imposes liability on individuals and companies who defraud governmental programs, including Medicare and Medicaid. It includes provisions that allow private citizens (whistleblowers) to file suits on behalf of the government against those who have committed fraud and receive a portion of any recovered funds.

Why is the False Claims Act important?

• Fraud prevention: Deters healthcare providers from submitting false claims to government programs.
• Financial recovery: Helps recoup billions in fraudulently obtained healthcare funds.
• Whistleblower protection: Provides legal protection for those who report suspected fraud.

Common false claims in healthcare

• Billing for services not rendered or unnecessary services.
• Upcoding to receive higher reimbursement than appropriate.
• Kickbacks for referrals involving federal healthcare programs.

How Solace can help

A Solace advocate can help you review your medical bills and insurance statements to identify potential billing errors or fraudulent charges. If concerning patterns are discovered, they can guide you through the process of reporting potential fraud, connect you with appropriate authorities, and help protect your interests if you need to act as a whistleblower regarding healthcare fraud.

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