The state’s healthcare system pays out millions of dollars every year to doctors, hospitals, and dentists. At the same time, it authorizes citizens to acquire benefits that often result in reduced-cost insurance plans.
A vital part of both these processes is the truthful actions of both patients and providers. Unfortunately, fraud is common in the healthcare industry. This can result in providers receiving improper payments or otherwise ineligible individuals collecting benefits. To identify and prosecuted these bad actors, the State relies on whistleblowers to come forward with essential evidence.
A Greenville healthcare fraud lawyer may be able to help you to serve in this vital role. This involves not just forming comprehensive complaints to submit to the State but also protecting you against potential retaliation.
As a general concept, fraud is always an illegal activity. However, more specific state laws prohibit an activity when it cheats the state out of funds. According to South Carolina Code § 8-27-10, it is a crime to commit any act that cheats or attempts to cheat the government out of money. Healthcare fraud can certainly fall under this umbrella.
For example, a doctor may demand payment for a recipient of health care under a state plan. This provider must be sure to properly itemize the services that they provided to patients in order to receive the correct compensation. Any intentional act to inflate these values or claim payments for services not rendered is a violation of state law. An experienced Greenville healthcare fraud attorney could provide more information about state fraud laws and help individuals to further explore their options if they suspect fraud.
Serving as a whistleblower comes with risks. Understandably, people may be hesitant to come forward if they suspect that they will suffer harm as a result. This can be especially intimidating for workers who are considering blowing the whistle on their employers.
Fortunately, retaliation against a worker who acts as a whistleblower is illegal. S.C. Code § 8-27-10 provides a civil cause of action for any worker who suffers adverse effects in the workplace because of their coming forward. Under this statute, these adverse effects can include termination, demotion, transfer, or harassment.
A Greenville healthcare fraud lawyer could take the lead in pursuing these cases. These cases can seek out back pay, reinstatement on the job, and even attorneys’ fees as compensation.
Healthcare fraud is a major problem that costs the state millions of dollars every year. Both providers who illegally charge for services and individuals who improperly receive benefits violate the law. In many situations, the State only learns of these violations because of whistleblowers that provide information about illegal activities.
If you believe that you have witnessed a violation of the state’s healthcare fraud laws, a Greenville healthcare fraud lawyer may be able to help. An attorney could perform an investigation into the incident, submit comprehensive complaints to the state, protect you from any potential retaliation, and even assist you to claim a reward for your information. Schedule a consultation today.