Each year, federal and state government-funded programs like Medicaid and Medicare are defrauded out of millions of dollars. Because tax dollars fund federal government programs, American taxpayers are who pay the price when companies or individuals defraud government programs.
Whistleblowers with valuable information regarding Medicaid fraud or other types of healthcare fraud against the government may be rewarded with compensation if their tip leads to the successful recovery of defrauded funds. If you have proof of Medicaid fraud, contact one of Tycko & Zavareei LLP’s Medicaid fraud attorneys in NYC for a free legal consultation.
What is Medicaid Fraud?
Medicaid fraud occurs when medical professionals submit falsified or intentionally misleading claims to government healthcare programs in order to procure unwarranted funds. According to the Center for Medicaid and Medicare Services, Medicaid was defrauded out of $86 billion in 2020, with more fraudulent billing likely going undetected. Despite this, the government relies primarily on the bravery of whistleblowers who are willing to come forward with tips on fraud against the government under the False Claims Act (FCA).
What is the False Claims Act?
The FCA helps fight fraud committed against the U.S. government by making it illegal to knowingly file or create a false record or claim in order to receive unwarranted federal funds. This includes submitting false records to government-funded programs like Medicaid in an attempt to claim more money than an individual or company may be entitled to.
The FCA allows private citizens to bring lawsuits on behalf of the federal government against companies or individuals committing fraud. If the information that this individual (the whistleblower) provides leads to the government successfully recovering defrauded funds, they will be entitled to 15-30 percent of the total amount recovered. Anyone can be a whistleblower, but it is usually someone with access to inside information about the fraud taking place, like an employee or contractor.
What is the New York False Claims Act?
The New York FCA, enacted in 2007 and modeled after the federal FCA, allows whistleblowers to file a qui tam lawsuit on behalf of the New York state government. The New York FCA protects whistleblowers and awards financial compensation for tips regarding fraud against the state government and its programs, including Medicaid.
In most cases, healthcare fraud qui tam lawsuits are filed at both the state and federal levels due to Medicaid and Medicare being funded by both state and federal governments. It is advisable to work with a New York City lawyer who is familiar with Medicaid fraud lawsuits and what it takes to succeed in them.
Examples of Medicaid Fraud in NYC
Medicaid fraud is committed by doctors, dentists, hospitals, pharmacies, nursing homes, and other healthcare companies. Healthcare workers or companies often seek to defraud Medicaid or Medicare in the following ways:
- Billing for goods or services that were not provided
- Billing for and performing unnecessary procedures or tests
- Charging services separately that are usually billed together, otherwise known as unbundling
- Submitting falsified or misleading records or bills
- Creating intentionally misleading cost reports
- Offering kickbacks or other bribes
- Marketing the use of pharmaceutical drugs or devices for off-label usage
If you have proof or inside knowledge of an individual or organization taking part in these or other forms of fraud against the government, like government contract fraud, contact Tycko & Zavareei LLP today to speak with a qualified whistleblower attorney.
Protections for Medicaid Fraud Whistleblowers in New York City
Potential whistleblowers with inside knowledge of Medicaid fraud often fear coming forward due to the risk of employer retaliation. In New York, whistleblowers are protected against whistleblower retaliation under both the FCA and New York FCA, as well as additional whistleblower protection laws. These laws make it illegal for an employer to retaliate against a worker for blowing the whistle on illegal activity.
Retaliation can include termination, suspension, demotion, withholding pay or benefits, harassment, discrimination, and other disciplinary action against an employee for becoming a whistleblower. If a whistleblower does experience employer retaliation for reporting Medicaid fraud, they may qualify to file a lawsuit for damages against their employer.
How Can an NYC Medicaid Fraud Attorney Help Me?
Qui tam lawsuits can be complex, so consulting with an experienced Medicaid fraud lawyer may be advisable if you’re considering filing a whistleblower claim in New York City. A qualified attorney can assist you with your NYC Medicaid fraud claim by:
- Evaluating your claim and determining whether it warrants bringing a Medicaid fraud whistleblower lawsuit
- Filing your claim under all appropriate whistleblower programs
- Urging the government to come onto your case, increasing the chance of significant financial recovery
- Helping ensure you receive the maximum financial reward for your valuable whistleblower information
- Protecting you from retaliation to the fullest extent of relevant whistleblower protection laws
Connect with a NYC Medicaid Fraud Lawyer Today
The lawyers of Tycko & Zavareei LLP are nationally recognized for their role in helping whistleblowers shed light on companies that defraud the government, including those that engage in Medicaid fraud. Our cases have led to the recovery of millions of dollars in defrauded funds, including a healthcare fraud case that settled for $350 million.
If you have proof of Medicaid fraud or other forms of healthcare fraud, you may qualify to receive a significant financial reward. Contact the NYC Medicaid fraud attorneys of Tycko & Zavareei LLP today for a free, confidential case evaluation.
