From our offices in the Detroit area, Akeel & Valentine, PLC serves clients nationwide.

From our offices in the Detroit area, Akeel & Valentine, PLC serves clients nationwide.

How can qui tam fight healthcare fraud?

On Behalf of | Feb 11, 2022 | Qui Tam

Qui tam allows someone to file a case under whistleblower protections. The person files the case on behalf of the federal government and they get to receive some of the damages awarded in the case.

The U.S. Department of Justice explains that qui tam can help the government to discover issues it may not have otherwise have known about or discovered. Most often these are situations in which the federal government has no knowledge any wrongdoing is occurring, and having citizens bring the cases to court helps them identify the issues and correct them.

Example case

One example of when qui tam helped within the healthcare system was in a case against Ascension Michigan and other hospitals. The hospitals were accused of submitting false claims to federal health care programs. The hospitals ended up having to pay $2.8 million.

The benefits

In this case, it allowed the government to go after medical facilities that were allowing doctors to make claims for procedures that were not necessary or never happened. Since the claims were made to federally-funded health insurers, it was taken taxpayer money. The qui tam case helped to recover money lost from the system, which means it goes back to people who are on the programs for legitimate needs.

Qui tam is a tool that lets citizens help the government to fight things like fraud. It enables costs to stay down and ensures programs can continue to run to help those who need them. Without qui tam, cases like the Ascension Michigan case would have never made it to court, and the misused funding from federal medical care programs would have been forever lost.

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