Nursing Home Fraud: How Important Are Nursing Home Whistleblowers in Exposing Them?

nursing home fraud

Healthcare fraud in nursing homes puts countless residents’ lives at risk and costs the government and taxpayers billions of dollars. Residents already struggle with the risk of neglect and abuse, but they likely have no idea the extent of medical fraud that often goes on behind the scenes. While the government is stepping up enforcement efforts by prosecuting the offending nursing homes, agencies don’t usually have a case without a whistleblower coming forward. Nursing home fraud is a growing problem that will continue to increase unless brave whistleblowers come forward. 

If you suspect nursing home fraud, contact Senior Justice Law Firm today. We specialize in nursing home injuries and medical fraud-related cases. Our lawyers can help you report suspected nursing home fraud. Whistleblower cases are complicated, and failure to follow the exact procedures could jeopardize your standing as a whistleblower. Because federal law protects qualified whistleblowers, you want to ensure you do everything correctly to obtain that status. 

Can Nursing Home Whistleblowers Get a Reward?

Yes, which is why you want to ensure you establish yourself as a whistleblower under federal guidelines and laws, such as the False Claims Act. Otherwise, you won’t be eligible for compensation or protection. The government recognizes the importance whistleblowers play in medical fraud cases. Therefore, whistleblowers might receive a percentage of the fraud they expose, possibly between 15% and 25%. That can be a substantial sum of money, depending on the amount of fraud. For example, if you uncover a $30 million fraud scheme, you might receive $4.5 million to $7.5 million in compensation. 

Examples of Nursing Home Fraud

Fraud can take many different forms. Some of the most common examples of nursing home fraud include the following: 

  • Double-billing for treatment and services;
  • Submitting bills for services, tests, and goods not performed or purchased;
  • Submitting falsified claims that exaggerate a resident’s medication condition;
  • Providing kickbacks in exchange for referrals;
  • Performing services, ordering tests, or administering medications that are unnecessary to increase billing; and
  • Inflating claims to support extra employee work hours. 

Many of these fraudulent claims involve Medicare and Medicaid billing. Employees at nursing home facilities play an integral role in uncovering fraud, especially regarding fraudulent Medicare billing practices. Another concern on top of fraudulent billing is what happens to the residents. Many residents are neglected and not receiving the care they deserve. That can also open the door to families filing nursing home abuse and neglect lawsuits. 

Reporting Nursing Home Fraud  

The proper procedure for reporting nursing home fraud involves qui tam actions. This legal action involves you filing a complaint against the nursing home on behalf of the government. Because these are very complex legal actions, hiring an attorney with experience is crucial. Otherwise, you can jeopardize your entire whistleblower status. Under the False Claims Act, employers cannot retaliate against whistleblowers who legally bring a qui tam action. 

Contact Senior Justice Law Firm

If you suspect fraud at the nursing home where you’re employed, contact the Senior Justice Law Firm immediately to schedule a consultation. We have years of experience with nursing home cases, including False Claims Act violations. We don’t recommend pursuing a whistleblower action without legal representation. Let us review the situation and assist you in determining the best course of action. We can help you gather evidence and prepare to file a suit against the facility if you have credible information that could lead to government action. Speak with one of our skilled lawyers today to learn more about whistleblower claims involving nursing home fraud. 

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