National Report Medicare Advantage Fraud Day is observed on September 12 each year. The Hesch Firm, LLC, has created a specific website dedicated to educating Americans on the types of Medicare fraud out there, as well as equipping them with ways to detect and report these frauds. The purpose of this day is twofold — to help whistleblowers follow proper protocol in order to ensure that the government investigates the fraud, and to reward whistleblowers for their service. We all face fraud of some kind or the other at least once in our lifetimes. In the U.S. particularly, 10% of Medicare funds are lost due to fraud. In reality, that is no small amount of money (roughly $65 billion each year); precipitating a healthcare crisis in the States!
History of National Report Medicare Fraud Day
National Report Medicare Fraud Day was founded in 2017 by The Hesch Firm, LLC. The day came to be after founding attorney, Joel D. Hesch, spent over 15 years working in the DOJ’s whistleblower reward office. He now exclusively represents whistleblowers across the country in filing for cases and reporting instances of fraud.
To help whistleblowers properly report Medicare fraud, Joel D. Hesch wrote a free e-book and created a website to ensure that everyone knows how to correctly report Medicare fraud and take the necessary steps to be eligible for a reward. You can visit www.ReportMedicareFraudDay.com to know more about the initiative.
Medicare fraud can be reported in two different ways and each way provides very different results. The first one is to blow the whistle under the Department of Justice (DOJ) reward program, which pays 15% to 25% of the amount the DOJ recovers. The average DOJ reward for reporting Medicare fraud is $690,000. While some have even claimed rewards as high as $150 million. If you report fraud under the DOJ program, the government is compelled to open an investigation and keep you updated on the progress. Presently DOJ whistleblowers constitute three-fourths of the government’s Medicare fraud reward cases. Thus, the government actually depends on whistleblowers to bring Medicare fraud cases to their notice and receive a reward in return. The second way to report Medicare fraud is directly to the Centers for Medicare & Medicaid Services (CMS). CMS runs the Medicare program. Fraud can be reported to the CMS through its website or by calling its hotline.
National Report Medicare Fraud Day timeline
Whistleblowing begins in England, where lawmakers rely on private citizens to detect and unmask illegal activities, in return for reward money.
Benjamin Franklin exposes the private letters of the governor of Massachusetts, revealing his deception of the Parliament.
Thanks to the increase in fraud cases over the course of the Civil War, this act is passed, giving whistleblowers the right to sue on behalf of the government and receive half the money if successful.
Medicare begins under the Social Security Administration.
Speech, physical, and chiropractic therapy are added to Medicare.
Hospice care is made available to the elderly.
Medicare program for covering almost all self-administered prescription drugs is passed.
Founded by The Hesch Firm, LLC, this day is instituted to ensure that whistleblowing is encouraged and rewarded.
The FBI uncovers a Medicare fraud scheme of $1 billion and charges 24 people.
National Report Medicare Fraud Day FAQs
What is the reward for reporting Medicare fraud?
Individuals who bring a case under the FCA are generally entitled to between 15 and 25% of whatever funds the government is able to recover.
What constitutes Medicare fraud?
Medicare fraud occurs when someone knowingly deceives Medicare to receive payment when they should not, or to receive a higher payment than they should. Committing fraud is illegal and should be reported.
What can I do about Medicare fraud?
If you suspect Medicare fraud, do any of these:
- Call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
- Call the fraud hotline of the Department of Health and Human Services Office of the Inspector General at 1-800-HHS-TIPS (1-800-447-8477).
What percentage of seniors choose Medicare Advantage?
According to data collected by the Kaiser Family Foundation, there has been a rise in the percentage of senior citizens enrolling in Medicare Advantage plans. The latest data shows this number is at 42%.
Why do doctors not like Medicare Advantage plans?
Many doctors feel that private insurance companies do not compensate them adequately for the medical services they provide, or else they make the payment process very difficult. With doctors losing out on money, patients also get impacted, as they may not receive the full extent of care which they may require, due to budgetary concerns.
How To Observe National Report Medicare Fraud Day
Trend it on social media
If you have ever reported a Medicare fraud you may want to share your experience using #ReportMedicareFraudDay on social media. Follow the hashtag to read more about such incidents.
Talk to the relevant attorney
If you know of a potential case, the best thing would be to bring it to the notice of a whistleblower reward attorney in order to find out all you need to know about the eligibility and validity of your claim. It is helpful to know who these attorneys are generally, and whom to trust with information.
Help someone in need
Know someone who’s been duped in a Medicare case? Help them file a complaint and tell them how they can claim their reward.
5 Facts About Medicare That Will Blow Your Mind
The wealthier you are, the more it’ll cost you
While most people will pay the standard premium amount, some individuals will have a higher premium based on their income.
It doesn’t cover all medical grievances
Medicare only covers 80% of eligible medical expenses.
It doesn’t cover some essential care
The original plan is limited to the U.S. only
The original plan is limited to the U.S. only
Medicare doesn’t pay for anything while you’re traveling abroad.
Medicare gives a free treat
Medicare offers a free annual wellness exam.
Why We Love National Report Medicare Fraud Day
Helps protect against fraud
With different firms and federal bodies collaborating together to put out proper information, people can now educate themselves on the different kinds of Medicare frauds out there. They can learn how to detect fraud and thereby protect themselves and their families from falling victim to the same.
The government’s whistleblowing reward program may not be known to many, though the rewards can be quite substantial. This is the kind of program which private citizens ought to be aware of. It can act as an incentive for people to actively report corruption and fraud in the healthcare system.
Encourages people to take action
Programs like the whistleblowing reward program can help motivate people to take action against corruption. This can have a positive impact on the number of fraudulent schemes in the healthcare system especially, and help senior citizens especially receive the care they deserve. It also empowers society as a whole to be more vigilant and proactive.
National Report Medicare Fraud Day dates