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What we can do for you?  The Quitam-Consult team consists of experts in the following areas:
- Healthcare Finance,
- Forensic Accounting,
- Hospital & Physician reimbursement, and
- Quitam Case Development and Investigation.
The collective expertise and experience of the team is available to the potential relators to discuss and evaluate the merits of any potential case. If the potential case has merits it can be investigated, developed and appropriate legal expertise obtained to proceed with the case. |
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Our ExpertiseQuitam-Consult.com specializes in healthcare qui-tam cases and has expertise in that area. In addition we work with a number of law firms all over the country, recognizing the expertise and resources available and selecting one depending, in part, upon the type of case and the physical location of the relator.
For discussing your potential quitam case in confidence with a Quitam-Consult consultant, please contact :
Information Desk |
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Healthcare Quitam CasesEarly quitam cases primarily involved defense contractors. Recently, however, case seeking recoveries on behalf of Medicare constitute 70% of all qui-tam cases. The False Claims Act has now become the government’s primary tool to recover funds for the US Treasury and to the Medicare Trust Fund. Healthcare quitam actions have historically been based upon the following:
- False submissions of claims that are not medically necessary or that are not otherwise allowable by Medicare, Medicaid or other governmental program.
- False cost reports of hospitals and other providers that fabricate or inflate reimbursable costs or mischaracterize non-reimbursable costs.
- Violation of health care laws, including the Fraud and Abuse and Anti-Kickback Laws, and the Stark Self Referral Laws, also give rise to False Claims Act liability.
- Upcoding and unbundling, whereby government health-care programs are billed for more expensive procedures than are warranted because the diagnosis is reported as more serious than is the case or the procedure actually performed is “unbundled” into components and billed separately for a higher total amount.
- Substandard patient care, if repeated and egregious, may be curtailed through application of False Claims Act remedies.
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