Healthcare fraud is a consistent problem in South Carolina. Every year, people and companies misappropriate millions of dollars in state funds through false insurance claims or other illegal activities.
The state government wants individuals to play an active role in combating this fraud. The whistleblower program invites people to report abuses to the South Carolina Department of Health and Environmental Control (DHEC). This agency can perform a full investigation into the incident and provide rewards if those investigations result in the recovery of funds.
A South Carolina healthcare fraud lawyer can help individuals looking to report fraud in the state. This includes assisting with filing an initial report, requesting a reward through a writ of Qui Tam, and shielding individuals from potential retaliation. Contact our firm to speak with a skilled attorney today.
The state’s various public health programs function on the concept that parties will only demand payment for legitimate reasons. This includes individuals requesting health insurance coverage as well as providers billing for services given to patients.
Any intentional act that results in an incorrect form or an attempt to deceive the state counts as healthcare fraud. S.C. Code § 8-27-10 further describes this concept as the intentional abuse, misuse, destruction, or loss of public funds. Concrete examples can include:
If any person or company intentionally performs these acts, they common healthcare fraud. A South Carolina healthcare fraud attorney could help people to perform an initial investigation into whether their observations constitute fraud.
As criminal defense attorneys can explain, healthcare fraud is a serious matter. Because the state is always interested in controlling the budget through cutting down on fraud, it is willing to provide a reward to people who serve as whistleblowers. Parties may request a reward by filing a writ of Qui Tam.
However, these payments are only available under limited circumstances. First, the investigation must result in a conviction that recovers funds. Second, the investigation must come about through the receipt of new information from the whistleblower. Finally, the whistleblower cannot be a member of law enforcement or any other party with a legal obligation to report fraud.
A successful writ of Qui Tam can result in a reward. This reward may be as valuable as 25% of the net savings that come about as the result of a successful investigation. A Medicare fraud lawyer could help with this.
Finally, it is important that people feel safe while serving as whistleblowers. S.C. Code § 8-27-10 states that any person who experiences retaliation in the workplace as the result of serving as a whistleblower has a cause of action to demand a remedy in civil court. These remedies can include:
A South Carolina healthcare fraud attorney could help to pursue these lawsuits in the event of retaliation.
Healthcare fraud in South Carolina can take on many forms. Regardless of the specific action that a party takes, it is illegal to intentionally act in a way that costs the state’s healthcare system money.
Individuals may come forward as whistleblowers to report this activity. If this report results in the recovery of funds, parties may collect a reward through a writ of Qui Tam.
A South Carolina healthcare fraud lawyer may be able to help you. An attorney can work to craft an initial complaint, author a writ of Qui Tam, and even pursue private lawsuits when serving as a whistleblower results in retaliation. Reach out today to learn more.
