New York State is one of 32 that have their qui tam statute. Like other statutes at the state and federal level, the New York State False Claims Act (NYFCA) empowers whistleblowers to file lawsuits against companies and individuals who submit fraudulent claims to the...
Medicare/Medicaid Fraud
Medicare/Medicaid Fraud
Whistleblowers help DOJ recover billions
The Department of Justice recovered over $1.6 billion thanks to qui tam whistleblower lawsuits in the fiscal year 2021, which is October 1, 2020, to September 30, 2021. The qui tam provisions under the False Claim Act empower private citizens to file lawsuits on...
DOJ takes first case involving data mining
In September of 2021, the Justice Department accused a health insurer in upstate New York and an affiliated medical data analytics company of cheating the federal government out of tens of millions of dollars. The civil complaint of fraud is the first to target a data...
Diabetic shoe company to pay $5.5 million
The Florida-based Foot Care Store, which did business as Dia-Foot, agreed to pay $5,538,338 to settle allegations that it violated the false claim act between 2013 and 2018. The settlement resulted from a former employee filing a claim – and they will subsequently...
Qui tam alleges auto insurance companies not paying back Medicaid and Medicare?
Three hundred and fifteen insurance companies are accused of leaving taxpayers with the bill. In what may be the largest whistleblower lawsuit in U.S. history, the multibillion-dollar whistleblower lawsuit alleges that the carriers did not cover the medical costs...
Classifying improper payments: Mistake, abuse or fraud?
Although it’s not possible to determine the exact cost of Medicare abuse, the exploitation of Federal healthcare is a serious issue in the United States. Together, Medicare fraud and abuse cost taxpayers billions of dollars and limit the effectiveness of the programs...
Is your company committing Medicaid fraud?
As a person and a professional, you likely feel certain obligations when you suspect or confirm wrongdoing. If you are in the healthcare industry, you may find yourself in a position to either speak or stay silent when an individual or company is taking advantage of...
Have You Noticed Time Discrepancies In Medicaid Billing?
There are many different forms of fraud that involve billing Medicaid. In some cases, a doctor, billing specialist or medical business will intentionally bill for drugs, procedures or services that were never administered or performed. In other cases, doctors or...
Vascular Access Centers accused of false billing, kickback scheme
Vascular Access Centers L.P., along with 23 subsidiaries and related corporations, has been accused of Medicare fraud, violating the False Claims Act, and violating the Anti-Kickback Statute and have agreed to pay at least $3,825 million to resolve the allegations. If...
Whistleblowing – How It Works, Why We Need It
Who are the most popular fraud targets? The U.S. and state governments. Why? Governments cannot possibly police each of their millions of transactions. But beware you Medicare false claimers, overcharging defense contractors, sales tax skimmers, and bill-padding...
