In 2012 alone, the False Claims Act (“FCA”) was responsible for recovering over $2 billion stolen through healthcare fraud, Medicare scams, and unlawful billing practices. Ending healthcare fraud has been a non-stop pursuit over the past several years due to the implementation of several programs and task forces aimed at eradicating this costly crime.
The HEAT Task Force, which stands for Healthcare Fraud Prevention and Enforcement Action Team, has been pivotal in the fight against Medicare and Medicaid fraud and continues to play an integral role in the investigative process.
Beginning in 2009, HEAT was created as a joint effort between the Department of Health and Human Services and the Department of Justice – agencies responsible for the investigation and prosecution of healthcare fraud.
HEAT Task Force Success
Over the past several years, HEAT has boasted a sharp increase in criminal charges and civil penalties assessed against those engaging in healthcare fraud. According to its website, the following statistics showcase the impact of this invaluable task force:
- HEAT actions have led to a 75 percent increase in healthcare fraud charges between 2008 and 2011;
- The HEAT Medicare Strike Force has successfully charged over 1,400 defendants responsible for collectively over-billing the government for more than $4.8 billion; and
- HEAT is also responsible for the largest single fraud prosecution to date, involving a $530 million fraudulent billing scam.
The Task Force also arms citizens with knowledge about how to recognize and report healthcare fraud in their local community. Specifically, officials encourage patients to always carefully review their bill to uncover any of the following:
- Charges for services that were never rendered;
- Billing for the same service twice; and
- Charges for services, referrals, lab work, or diagnostic imaging that your doctor did not order.
HEAT and the Whistleblower
If you are a Medicare or Medicaid patient and you suspect fraud by your doctor, you should speak with a whistleblower attorney right away. From there, you may be able to file an individual lawsuit under the False Claims Act, which prohibits false claims for reimbursement on behalf of Medicare and Medicaid patients.
Under the rules of the FCA, the government has an opportunity to review your lawsuit and decide whether it would like to intervene in your case. If the government decides to intervene in your healthcare fraud case, it will implement the investigative tools and resources available to the HEAT Task Force in order to unearth as much evidence of fraud as possible, resulting in the maximum possible recovery on behalf of taxpayers.
The government does not opt to intervene in every case; however, you are strongly encouraged to report your information as soon as possible. If your whistleblower case results in a settlement or judgment against the fraudulent party, you can recover up to 30 percent of the recovery amount as your reward for coming forward.