Experts estimate the U.S. health care system wastes $765 billion annually — about a quarter of all the money that’s spent. Of that, an estimated $210 billion goes to unnecessary or needlessly expensive care, according to a 2012 report by the National Academy of Medicine.
However, federal law requires that any doctor or hospital which furnishes health care services that may be reimbursed under Medicare, Medicaid, or TRICARE must ensure that, to the extent of his or her authority, those services are provided “only when, and to the extent, medically necessary.” See 42 U.S.C. § 1320c-5(a); 42 C.F.R. § 1004.10.
If you are aware of such practices, the False Claims Act empowers you to bring an action on behalf of the government to seek reimbursement from those committing this fraud. Whistleblowers could be rewarded up to 30% of the recovery.