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Healthcare fraud cases under the False Claims Act have grown significantly in recent years. With millions of Americans insured, in whole or in part, by health insurance paid for with federal or state government funds, healthcare spending in the United States continues to grow. 
 
With more than $3 trillion flowing through the entire health care system and insufficient accountability, there has been widespread fraud in both public programs and private insurance.  Luckily, billions of dollars in health care fraud have already been exposed, largely through the efforts of qui tam whistleblowers acting under federal and state false claims acts. However, billions of dollars in additional fraud remain undetected. 
 
Whistleblowers are crucial. The Government alone cannot effectively combat health care fraud. Whistleblowers under the federal and state false claims acts have detected and brought to light billions of dollars in fraud that would otherwise go undetected. 

There are many ways in which businesses and individuals have defrauded, and continue to defraud, federal and state government health care programs.

Examples of fraudulent conduct include:

  • Anti-Kickback Act Fraud

  • Stark Act Fraud

  • Medically Unnecessary Services Fraud

  • Upcoding Fraud

  • Unbundling

  • Durable Medical Equipment Fraud

  • Hospice Fraud

  • Home Healthcare Services Fraud

  • Pharmaceutical Fraud

  • Grant/research Fraud

  • Cost Report Fraud

  • Telemedicine Fraud