Fraud in South Carolina’s nursing homes can take on many forms. At the individual level, these facilities may defraud individual residents by violating the nursing home patients’ bill of rights. From a broader perspective, incidents of fraud involving Medicaid can cheat the federal government out of millions of dollars.
Thankfully, there are steps that private citizens can take to clamp down on these activities. Both the state and federal governments have whistleblower programs and protections that encourage people to come forward. If the resulting investigations recover funds, whistleblowers may even receive a cash reward.
A South Carolina nursing home fraud lawyer may be able to help you with this process. This can include filing an initial report, demanding a reward through the Qui Tam process, and protecting you from potential retaliation.
South Carolina has enacted a nursing home resident’s bill of rights. This collection of laws states that nursing home employees and ownership cannot take advantage of their residents. Prominent examples of behaviors that violate these provisions include:
The South Carolina Department of Health and Environmental Control (DHEC) takes a direct interest in investigating and punishing these abuses. Furthermore, the Department may issue a reward through the Qui Tam program if an investigation results in a financial recovery. A nursing home fraud attorney in South Carolina could take the lead in filing reports alleging violations of state law.
The federal government also has a hand in the day-to-day activities of nursing homes. This is because most nursing facilities and long-term residences receive money through Medicaid. Medicaid may pay some or all the fees of residents who are unable to pay themselves. As a result, nursing homes must provide accurate and timely documentation to Medicaid.
An intentional failure to follow these rules may constitute fraud. Specifically, 31 United States Code § 3729, the False Claims Act, says that it is illegal for any party to take any intentional act that results in the improper payment of funds. Examples can include overbilling for services or collecting payments for residents no longer living at the facility.
Much like under state law, federal nursing home fraud investigations may result in the payment of reward money through the Qui Tam program. Under 31 United States Code § 3730(c)(5), this reward will be between 15 and 25 percent of the total funds received as a result of a successful investigation. A South Carolina nursing home Qui Tam lawyer could help to pursue these rewards.
Most private citizens have an opportunity to serve their communities by reporting nursing home fraud. This includes acts that violate state law and those that involve Medicaid fraud. In both situations, it may be possible to collect a monetary reward through a writ of Qui Tam.
A South Carolina nursing home fraud lawyer is here to help. An attorney can prepare an initial report, file an official request for Qui Tam funds, and even pursue private lawsuits if your report results in retaliation. Contact an attorney today to learn more.