Medicare, like many other insurers, often pays doctors a standardized rate based on the service they performed. Open heart surgery costs $Z, a blood test for cholesterol costs $Y, and a physical costs $X. Upcoding is a fraud that centers on healthcare providers submitting improper medical codes to insurers for reimbursement, generally for improperly high […]

The basic principle of the False Claims Act (FCA) is simple. The law empowers whistleblowers to sue contractors that are allegedly defrauding the government and share in any recovery. The goal was to incentivize those with information about fraud against the government to come forward, report the fraud, help recover taxpayer dollars lost to fraud, […]