5 Things You Should Do When You’re A Victim Of Medical Fraud

If you’re a victim of medical fraud, prompt legal action is vital. You should be one step ahead of the at-fault party to ensure that all pieces of evidence are gathered and well-documented. Otherwise, you might end up being a pissed whistleblower, wasting your time and effort.

The healthcare industry is also faced with the biggest legal challenges, including medical malpractice, data breach, telemedicine, and false claims. That’s why if you suspect that you’re a victim of medical fraud, medical fraud legal consultation is crucial.

In this post, you’ll learn the important things you need to do when you’re a victim of medical fraud. 

What Is Medical Fraud

Medical fraud or healthcare fraud is any dishonest and deliberate act committed, resulting in an unauthorized benefit to the doer in replace of causing harm to the recipient or victim. 

Here are some examples of medical fraud: 

  • Misrepresenting of the individual who renders the service
  • Billing for not rendered services or items 
  • Billing for improperly documented services 
  • Seeking reimbursement or increased payment for correctly billed services at a lower rate
  • Misrepresenting the level or type of service provided
  • Billing for medically unnecessary items and services 
  • Seeking reimbursement or payment for procedures and other services rendered (integral to other procedures that are performed on the same service date)

Listed below are the things you should do if ever you find yourself a victim of medical fraud:

1. Report Medicare Fraud 

Medical Fraud

The United State’s national health insurance program, Medicare, has always been there to provide healthcare financial assistance since 1966. However, false claims increasingly arise, and victims grow in number as the years go by. While you can always report Medicare fraud using online channels, it’s important to contact your lawyer to ensure that you’re doing the right legal steps. 

Here are the advantages of speaking with a lawyer if you’re a victim of medical fraud:

  • Reporting Medicare fraud to an experienced lawyer will give you peace of mind knowing that you’re taking appropriate legal actions without incriminating yourself.
  • If the amount of the false claim is tremendous, it can significantly affect your future claims, so expert legal advice and actions are necessary. This way, you can obtain the maximum amount of compensation or resolution your case deserves.

2. Gather And Preserve Evidence

In medical fraud, substantial evidence is a must, such as medical billing documents, laboratory results, and other diagnostic procedure findings. Aside from presenting yourself as a victim of healthcare fraud, you need to ensure that all pieces of possible evidence should be kept intact. 

Of course, your medical fraud lawyer will help you gather and preserve evidence so you’ll be rightfully compensated. That’s why choosing the best lawyer to represent you is very important, someone who is experienced in looking for foolproof evidence to strengthen your case.

3. Know The Course Of Federal Investigation

With the help of a medical fraud lawyer, you’ll be oriented on how the federal investigation will proceed. Other people with similar cases and possible whistleblowers will be interviewed to support your case and take the matter to court. Careful legal preparation will be planned to ensure a successful case.

4. File A Lawsuit

For victims of medical negligence, ineffective medications, or faulty medical equipment or devices, a lawsuit can be filed against the healthcare provider, pharmaceutical company, or manufacturer. A medical fraud lawyer can help you go through this process to ensure a higher success rate.

You’ll be educated on your legal rights and the legal options available before filing a lawsuit, and proceed in this course as necessary, most especially if there’s strong evidence that may also compromise other people’s lives.

5. Whistleblowers Should Seek Protection

The government offers full protection and reward to whistleblowers of medical fraud. It is because there are safety and legal risks involved going against the giants of the healthcare business world. 

Here are some things a whistleblower needs to know:

  • A whistleblower should prove that efforts have been made to correct or stop improper actions violating the False Claims Act. 
  • The protection of the retaliation statute is applied if the whistleblower believes that the employer is violating the False Claims Act.
  • A whistleblower can recover damages for losses sustained because of holding benefits or wrongful termination.


If you’re a victim of medical fraud, you have to report the case. Medicare false claims or billing can be reported directly to Medicare through their website. However, it’s still best to hire a competent medical fraud lawyer to ensure that you take the appropriate steps.

Also, it’s important to gather the right evidence to prove your case and know the course of federal investigation so you can prepare yourself for court proceedings. Divulging medical fraud would significantly affect your life, most especially if you’re a whistleblower. That’s why your legal protection and your and your family’s safety should be prioritized at all times.

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