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- Cause
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- United States
- Date change rule:
- Every August 21
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National Report Upcoding Fraud Day shines a light on healthcare fraud every August 21. This day, founded by former Department of Justice attorney Joel Hesch, provides crucial awareness and clear steps for the public to report unethical healthcare providers. Take action to protect Medicare funds and ensure justice.
Want to sponsor National Report Upcoding Fraud Day? Learn how
Expected National Report Upcoding Fraud Day Deals
National Report Upcoding Fraud Day focuses on education and advocacy rather than commercial deals. Organizations like the National Whistleblower Center and Taxpayers Against Fraud offer resources and support for individuals considering reporting fraud. Legal firms specializing in whistleblower cases, such as Phillips & Cohen LLP, often provide free consultations and guidance on navigating the complex process of filing a False Claims Act lawsuit. Look for webinars and informational sessions from compliance associations like the Health Care Compliance Association (HCCA). We encourage you to visit the official websites of these organizations for valuable information and ways to get involved.
Platform Guide for National Report Upcoding Fraud Day
Tag National Today (linkedin.com/company/nationaltoday) and use #UpcodingFraud. Share insights on healthcare compliance and the importance of ethical practices in the workplace.
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Mention @NatlToday and use #ReportFraud. Join conversations about healthcare transparency, whistleblower protection, and the fight against financial abuse in the medical system.
Mention National Today (facebook.com/nationaltoday) and use #HealthcareFraud. Share educational posts and resources from advocacy groups to raise community awareness about upcoding.
National Report Upcoding Fraud Day Hero
Joel Hesch
History of National Report Upcoding Fraud Day
National Report Upcoding Fraud Day began in 2017 when attorney Joel D. Hesch left public practice to help whistleblowers report healthcare fraud. Hesch spent more than 15 years as an attorney at the Department of Justice (D.o.J.). During his stint at the D.o.J., Hesch helped the government recover about $1.5 billion from Medicare fraudsters. What did he find the most rewarding? Supporting whistleblowers report Medicare fraud via the correct redressal systems and claim rewards. Whistleblowers hesitate to speak up for fear of retaliation. Hesch not only ensured they filed rewards, but he also showed them the proper (therefore, safe) protocols.
Hesch even authored a book and published a website to make this information more accessible. The resources explain various kinds of healthcare fraud and how to report them. Each misdemeanor is vastly different from the next, along with its reporting mechanisms and desired results.
One of the most prevalent ways to cheat Medicare is through upcoding bills. Upcoding is an illegal practice where healthcare providers submit inaccurate billing codes to insurance companies. In essence, the codes submitted would reflect treatments that never happened. Medicare and Medicaid offer code-based reimbursements. Hospitals using the code for bronchitis receive a set amount regardless of the total payment cost. If they were to use the code for pneumonia, the amount paid would be more since treatment costs for it tend to be higher. Upcoding fraud refers to healthcare providers using higher-paying codes to get more money.
Hesch details the proper ways to report upcoding fraud in his free e-book. He also led the movement to create a national day for reporting healthcare fraud. The goal is to arm the general public with the knowledge and facts necessary to claim rewards and prevent healthcare fraud.
National Report Upcoding Fraud Day timeline
Congress passes the False Claims Act to address rampant corruption by defense contractors during the Civil War.
President Lyndon Johnson signs legislation establishing the Medicaid and Medicare programs.
Joel Hesch leaves behind a 15-year career as an attorney at the Department of Justice and establishes the Hesch Firm L.L.C.
A Florida chiropractor illegally obtains loans from COVID-19 relief programs and submits false reimbursement claims to Medicare.
How Businesses Can Celebrate National Report Upcoding Fraud Day
Local businesses, particularly those in the healthcare sector, can honor National Report Upcoding Fraud Day by reinforcing their commitment to ethical billing and transparency. Conduct internal audits and provide training sessions on compliance best practices for all staff. Businesses can also support whistleblower hotlines or offer clear, confidential internal reporting mechanisms to encourage employees to come forward with concerns without fear of retaliation.
National Report Upcoding Fraud Day FAQs
When is National Report Upcoding Fraud Day?
National Report Upcoding Fraud Day 2026 falls on Friday, August 21. It’s an important day to learn about and take action against healthcare fraud.
How much money is lost to healthcare fraud annually?
According to the day’s founder, Joel Hesch, fraudsters siphon off approximately $65 billion each year in Medicare fraud alone. Upcoding is a significant contributor to these losses.
What is upcoding fraud?
Upcoding fraud involves healthcare providers submitting inflated claims for reimbursement by misrepresenting the complexity or severity of services rendered. It’s a prevalent type of fraud that directly impacts Medicare and other insurance programs.
What is the role of a whistleblower in reporting fraud?
Whistleblowers play a critical role in exposing healthcare fraud, often providing the initial information that leads to investigations and successful prosecutions under the False Claims Act. They are essential in recovering taxpayer money.
How to Observe National Report Upcoding Fraud Day
Seek legal counsel
Do you have good reason to believe someone is committing healthcare fraud? Gather the facts and speak to a whistleblowing attorney right away.
Read up on the law
Familiarize yourself with the laws. Whistleblowing provisions vary across states and types of fraud. Understand them so that you know what to expect.
Take a different view
Contrary to perception, whistleblowers aren’t snitches. They put themselves at grave personal risk for the public interest. Encourage yourself and others to view whistleblowing in a positive light.
5 Facts About Healthcare Frauds That Will Blow Your Mind
Pain with no gains
In 2014, the F.B.I. discovered a Detroit oncologist prescribing painful cancer treatments to patients who did not have cancer and some of whom died.
Inaccurate drug price reporting
A company called Sandoz paid a $12.64 million settlement for misrepresenting drug pricing to Medicare.
Medical scam mastermind
In 2011, authorities prosecuted a healthcare administrator who connected patients with doctors to perform surgeries they didn’t need.
Unnecessary drug tests for kids
A group of scammers recruited children for a bogus after-school program where drug tests at a lab were mandatory.
N.F.L. retirees and false claims
Three former N.F.L. players submitted claims worth $2.5 million for medical equipment they never used.
Why National Report Upcoding Fraud Day is Important
Helping us get it right
We believe people can be inherently good. A day that offers tools (facts and accurate information) to do the right thing is what everyone needs.
The greater good
Reporting upcoding and other kinds of fraud can prevent injustice. Companies should not make profits off of people’s illness and suffering.
Sensitization and awareness
It’s high time we remove the stigma around whistleblowing. Without the fear of backlash, many more people may come forward with information about fraud.
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