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Medicare Fraud Whistleblower Retaliation
Anonymous5 views2 answers
I reported a doctor in Florida for billing medicare for services not rendered, and sending unlicensed Nurses to my house to visit my mother in-law bed ridden for life 87 years old. On the next day, his office called DCF to falsely accuse us of refusing treatment for my mother in-law in response to a letter from my wife asking to speak to the doctor to discuss other treatment options and he never called us after for more than 2 weeks trying to talk to him or have him come see my mother in-law. Further, on October 25, 2013 we received a certified letter discharging my mother in law for non-compliance when in fact we just wanted to talk to the doctor about other treatment options and we were not refusing treatment.
Typically, anti-retaliation suits result from employees reporting an act of an employer. The reason for this is that there is (at some level) the necessity to prove harm has occurred as a result of the retaliation. In this case you want to know whether you (the family of a patient) can file such a suit, then don't really specify any genuine damage.
What seems to have happened is that you got in a fight with your mom's physician who decided it wasn't worth the effort and then your mom was fired as a patient for non-compliance with medical care. In addition, there does seem to be some 'he-said, she said' going on in this matter, and the reported 'stroke' of the physician.
In short, the waters on this one are pretty muddy, so I suggest you can take your facts to a local attorney and get an opinion.
Good Luck with this.
Your question does not provide detail about the billing for services not rendered. If there is proof of fraudulent billing of Medicare and the physician is or has done this on a systematic basis, there could be grounds for a qui tam suit.
This is a type of action in which a private citizen files a complaint alleging that someone has cheated the federal government. The private citizen files the suit under seal and serves it upon the United States. The Justice Department then has a period of time while the suit remains sealed to determine whether to intervene and take over its prosecution. If DOJ chooses not to do so, the person bringing the action, known as a "relator," may continue the suit himself or herself. Typically, the decision by DOJ to intervene or not determines whether the case goes forward. If the case does go forward successfully, the court will award the relator a percentage of the recovery.
These types of cases are usually brought where there has been a large ongoing fraud that will result in a significant recovery for the United States.
If you believe that the facts in your case establish a systemic fraud against Medicare, I suggest that you contact an attorney to discuss the possibility of bringing a qui tam suit.
