Medicare/Medicaid Fraud Whistleblower

You are employed by a hospital, health clinic, pharmacy, doctor or other provider of medical services or products. You notice that your employer is cheating the government by submitting false Medicare or Medicaid claims, and you don’t think it’s right.

The United States False Claims Act, the New York State False Claims Act and the New York City False Claims Act encourage you to let the government know that your employer is cheating. Under the False Claims Act, you are a “relator”, a sort of private detective who provides information of employer Medicare or Medicaid Fraud, and you assist the government as a so-called “qui tam” complainant in helping the government catch employer tax Medicare or Medicaid cheats. False Claim Acts have a long history, and go all the way back to the colonial period. During the Civil War, corrupt contractors sold the government sick horses, spoiled food and faulty fire arms and ammunition. The government wants and needs to protect itself and your tax dollars.

You are enabled and protected by the United States False Claims Act, the New York State False Claims Act and the New York City False Claims Act if you bring the employer cheating to light. False claim situations include where your employer cheats in billing the government for medical services or products. Some examples are kickbacks, double billing, upcoding, services without medical need, untrained personnel for services, unsupervised or unlicensed workers, use of unapproved drugs, inadequate care, use of substandard equipment, forgery of physician’s signatures, use of phony insurance carriers and unbundling of medical services. An employer who cheats the government is subject to high civil penalties, up to three times the amount of money that the employer defrauded the government as well as penalties of up to $12,000 per false claim. You, as whistleblower, relator or “qui tam” complainant could be entitled to up to 30 percent of the amount of the fraud, provided you are an “original source” and have not obtained the information of fraudulent conduct from public sources, such as from news media. The Affordable Care Act (“Obamacare”) expanded coverage so that in certain public disclosure situations there is more discretion to entertain a claim, and an “original source” can be a whistleblower who adds material new information to information that has already been publicly disclosed. Also, claimants can now include employees, but agents and independent contractors as well.

You may be afraid to bring the false claims to light, but you should know that the False Claims Acts protect you from employer retaliation. If your employer fires you for your complaints that the employer is cheating the government, you may be entitled to receive double the amount of back pay plus interest, reinstatement and compensation for “special damages” under the False Claims Acts.

Contact us online or call us at (212) 949-1001 so that we can review if your New York City employer has made false Medicare or Medicaid claims, or subjected you to retaliation when you complain about employer cheating on Medicare and Medicaid claims in violation of the False Claims Act in New York State or New York City.