A majority of False Claims Act cases filed by whistleblowers include allegations of Medicaid fraud

Georgia Attorney General Chris Carr announced that the office’s Medicaid Fraud Division recovered more than $8.5 million in taxpayer dollars in the 2019 federal fiscal year. Some of the recoveries were via qui tam cases (including by Bracker & Marcus LLC), brought under the Georgia False Medicaid Claims Act.

“Through hard work and persistence, our Medicaid Fraud Division has once again recovered millions of dollars for the taxpayers of Georgia,” said Attorney General Chris Carr. “Fraud and abuse within our publicly-funded programs harms our state’s most vulnerable citizens, takes advantage of those who play by the rules, and will not be tolerated by our office.” The Division has approximately 500 active investigations.

Here are a few examples of Medicaid fraud:

  • Mental health counselors billing the program for individual therapy services to juveniles when the children were simply attending an after-school daycare.

  • Door-to-door “marketers” offering individuals cash or gift cards to provide their personally identifying health information that is later used to bill for medically unnecessary lab services.

  • Scams involving durable medical equipment, such as back braces, where individuals receive this equipment without ever requesting or needing it.

  • A physician billing for office visits when he is out of the country.

  • Medical practices using unlicensed or untrained staff to provide services that require training and licensing from the State.

  • The diversion of personally-directed waiver funds to individuals who never provide services to the Medicaid beneficiary.

  • The billing of ambulance services for personal trips or errands.

  • An unlicensed personal care home taking in patients, diverting their benefits and depriving them of appropriate care.

Bracker & Marcus LLC has brought cases under the federal and state False Claims Act statutes alleging each of these types of schemes. if you suspect Medicare or Medicaid fraud, contact us for a free consultation.