Nursing Home Fraud: Litigating on the Government’s Behalf

When the False Claims Act, or what is more commonly known as the Whistle Blowers Law, came into effect, it was to help the government fight back against companies that were charging the government for goods or services they were not actually providing during the Civil War. Created by President Abraham Lincoln himself, the False Claims Act has developed to include any contractor providing services to the government.


Medical Providers Frequent Offenders

In recent years, medical providers have been among the most frequently prosecuted contractors under the False Claims Act. These providers, who accept Medicare, Medicaid, and some forms of Social Security, have been caught overcharging for medications or procedures, charging for services that were not provided, or providing unnecessary services just so they could collect payment. If you suspect that a medical facility or provider is committing fraud against a government program, there are many online resources, including, that can assist you in completing the appropriate steps to file a claim.

The largest offenders over the last few years have been nursing homes. With an increasing population of people who need these services, many unscrupulous nursing homes have taken advantage of this and started over billing Medicare.

Common Forms Of Nursing Home Fraud

  • Separating Treatments. Medicare negotiates prices for services. Many of these negotiations require the provider to offer package deals. For instance, a checkup may include specific blood tests as part of a routine exam. However, these doctors schedule independent sessions for an exam, conducting separate tests each time so they do not have to charge the discounted package rate.

Personal Care Services. These homes are billing the government for personal care services that the clients are not receiving. Many of these clients do not even need special bathing procedures or cleansers.
• Medical Supplies. The nursing home bills the government for medical supplies, such as electric wheelchairs or diabetic supplies and then keeps the actual product as stock for their home. In some cases, the merchandise was never purchased.
• Over Testing. Sometimes a headache is just a headache. However, these nursing homes are responding to simple events as a headache with outrageous treatment plans so they can bill for the procedures. This overtreatment often causes more stress to the patient then the initial problem.

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Whistleblower Attorneys Are Making An Impact

Many attorneys have found themselves outraged by this practice and have begun to litigate for the government against these fraudulent providers. Working as a representative of the whistle blower, these attorneys are aggressively working towards stopping this type of fraud.

Medicare fraud impacts everyone, but it impacts the taxpayer the most. Medicare payments are made from tax money. If these doctors are making fraudulent claims, they are stealing from the people. Taxes increase and services decrease when this type of fraud takes place.

Attorneys are encouraging anyone who has proof of this type of fraud taking place to step forward. As a whistleblower, you have special protections under the law, and you are entitled to a portion of the recovery if the government is able to recoup what it has overpaid to the offender.

In the end, the more of these fraudulent acts that can be stopped the better. These nursing homes are there to provide a service to the part of the population that needs their services. They are not there to provide these companies with a way to commit fraud at their expense.


Valerie Stout Cyrus is a freelance writer who frequently researches issues involving fraud on government programs. The Attorneys of Goldberg Kohn, at, present many relevant resources for litigating against fraudulent medical providers and nursing homes

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