Before getting reimbursed by Medicare or Medicaid, a healthcare provider submits a bill to the government program certifying that the provider earned the services requested and has complied with all billing requirements. A common healthcare fraud scheme involves doctors submitting bills for services not actually rendered. The schemes can be as blatant as doctors fabricating entire visits, but can be more subtle, such as where a doctor sees a patient for only a short time, but bills for a service that cannot be adequately completed during that duration.
Medicare and Medicaid rely heavily on the integrity of doctors and their certifications. When doctors go bad and submit false claims, fraud is often difficult to detect and goes unnoticed without the aid of whistleblowers. If you believe you have evidence of doctors billing for services not provided, you may have a strong whistleblower claim, and should seek immediate legal advice.