Reuters: Lawyers start mining the Medicare data for clues to fraud

A doctor checks the blood pressure of a patient at the J.W.C.H. safety-net clinic in the center of skid row in downtown Los Angeles July 30, 2007. REUTERS/Lucy Nicholson

A doctor checks the blood pressure of a patient at the J.W.C.H. safety-net clinic in the center of skid row in downtown Los Angeles July 30, 2007.

CREDIT: REUTERS/LUCY NICHOLSON

(Reuters) – Within hours of the U.S. government’s unprecedented release last week of a trove of Medicare billing data, a small fraternity of lawyers who specialize in representing whistleblowers in healthcare fraud cases began to mobilize.

These lawyers earn their living bringing cases on behalf of employees at drug companies and healthcare providers who believe their bosses or colleagues may be cheating the federal Medicare system by bribing doctors to prescribe certain drugs, for example, or inflating bills.

A whistleblower who prevails gets up to 30 percent of whatever the government recovers, and 40 percent of that reward typically goes to the whistleblower’s lawyer. 

Whistleblower cases can result in huge settlements, such as the $3 billion GlaxoSmithKlinepaid in 2012 to resolve claims that it promoted drugs for unapproved uses and failed to report certain safety data.

Patrick Burns, co-director of Taxpayers Against Fraud, a nonprofit advocacy group with around 400 whistleblower lawyers as members, said that right after the release on Wednesday a handful of lawyers asked him for help accessing the data, which is available online. The 2012 data runs for 10 million lines and shows how many times some 880,000 medical providers billed for a particular service, how much they charged and whether that deviated from the national norm.

Continue reading here: http://www.reuters.com/article/2014/04/14/us-data-idUSBREA3D05820140414

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