According to a new report, the rising cost of Medicare to taxpayers is 47 percent thanks to fraud, abuse, and overcharging by hospitals. New drugs and patient treatments have only been responsible for 6 percent of the rising costs. The problem is systemic but many Americans lack knowledge of how the program works, making lawmakers hesitant to propose legislation to combat the exploitation and abuse of America’s Medicare program.
“In the absence of the actions of lawmakers, individuals aware of entities exploiting the government for payment of false claims have powerful tools they can use to combat the fraud they observe,” commented James Kauffman, an attorney with the Levin, Papantonio law firm who practices in the areas of qui tam or whistleblower and False Claims Act litigation. “The Federal False Claims Act provides protections for whistleblowers that want to come forward and go toe-to-toe with companies and individuals they know are cheating the government, and by extension, taxpayers.”
In 2012 alone, the Federal False Claims Act was responsible for recovering almost $5 billion according to the Department of Justice. From 2009 through 2012, the Department of Justice recovered over $9.5 billion from Medicare and Medicaid related false claim suits. The picture illustrated by these statistics is one of increased reliance by the government on whistleblowers to come forward and protect the interest of taxpayers.
Unfortunately, the public rarely has a clear picture of how Medicare and Medicaid work. It’s even more unlikely to find individuals aware that the program suffers from persistent and pernicious fraud from health care providers.
“In my practice, I have seen many cases that, without the action of a brave insider or knowledgeable whistleblower, would have never been exposed,” Mr. Kauffman said.
Joshua is a writer and researcher with Ring of Fire.