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Examples Of Whistleblowing In Health Care

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Whistleblowers and Health Care Fraud
There are several obstacles to detecting fraud in health care. For example, a patient will have treatment described in a medical chart but will have diagnostic billing codes in a separate billing statement. While a payer could request the chart for comparison with the billing statement, the simple volume of work makes this routinely infeasible.
Since these two pieces of information are together in the medical facility that provided treatment, individuals working in these offices are most likely to know if fraud is occurring. Detecting fraud depends on honest medical workers disclosing their concerns.
The law that makes it possible to expose billing fraud is the False Claims Act (FCA), which dates back

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