Medicare fraud and medical malpractice

When we trust medical professionals, we expect them to adhere to the highest ethical standards, guided by the Hippocratic Oath, to do no harm. Unfortunately, not all medical practitioners uphold these standards which can lead to a medical malpractice claim. Some even engage in deceitful practices like Medicare fraud.

This is not a small problem – Medicare fraud costs billions annually, leading to higher healthcare costs and insurance premiums. It also diverts resources from necessary patient care, diminishing service quality. Understanding the full spectrum of Medicare fraud and malpractice issues is crucial for protecting patients and ensuring justice.

DWK Law represents clients who have fallen victim to doctors who practice predatory medicine. If you or a loved one has been taken advantage of in this way, contact our Orlando medical malpractice attorneys for a free consultation to discuss whether you’re entitled to compensation. Call today (407) 244-3000 today.

This story hits close to home

Most doctors consider the Hippocratic Oath of doing no harm to patients a sacred ethical statement that guides them through their careers. Unfortunately, some doctors prey on their patients for financial gain. One way these unethical doctors accomplish this is through Medicare fraud.

Doctors can commit Medicare fraud in several ways that patients never suspect. Consider one of our clients who was the victim of one such doctor. After this doctor performed multiple unnecessary procedures, our client lost his leg from the knee down. Before the procedures, he had only a 5% chance of losing his leg. This horrific result was completely avoidable. Our expert carefully examined the medical records and concluded that none of our client’s twelve procedures were necessary.

This fraudulent doctor targeted everyone who walked into his office, but he particularly focused on some of the most vulnerable people in society: older people with health issues. Patients with no spouse or children are especially ideal targets for these doctors, as there is no one to file a medical malpractice case should they die because of the malpractice.

Detecting and reporting Medicare fraud

Recognizing fraudulent practices

Patients and their families should be vigilant. Signs of Medicare fraud include receiving bills for services not rendered, services that seem excessive for the condition, or notices from Medicare about services you did not receive.

How to report fraud

If you suspect Medicare fraud, you can report it to the Medicare Fraud and Abuse Hotline. Prompt reporting can prevent further harm and initiate timely investigations.

Legal definitions and distinctions

Medicare fraud involves claiming Medicare reimbursement for non-performed services, whereas medical malpractice refers to negligence or omission that results in patient harm. Both severely impact patient trust and care quality.

Common fraudulent practices

These include unnecessary procedures, as seen in our client’s case, where unwarranted surgeries led to severe personal losses and more direct fraud like phantom billing and upcoding services.

Steps to mitigate fraud

Medicare and healthcare agencies increasingly use predictive analytics and audits to flag suspicious activities. As a patient, always review your Medicare statements and seek second opinions before undergoing significant procedures.

Legal recourse and compensation

Medicare fraud and malpractice victims can seek legal recourse through civil compensation claims. Damages may include medical costs, pain and suffering, and punitive damages in egregious fraud cases.

Compensation depends on the extent of harm and loss, and factors like age, health status prior to the incident, and future medical needs are considered.

Monitoring and enforcement

Agencies like the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) play significant roles in monitoring healthcare practices and enforcing laws against fraud. Private healthcare providers adopt more robust compliance programs to detect and prevent fraudulent activities.

We can help you navigate this challenging time

If you suspect that you or a loved one has been taken advantage of, it is critical to seek both medical and legal help promptly to address the issue and prevent further exploitation.

Reaching out to knowledgeable attorneys specializing in Medicare fraud and malpractice, like DWK Law, can provide the necessary guidance and support to navigate these challenging issues. Call (833) 243-9529 or contact us online today.