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Blowing the Whistle on Medicare and Medicaid Fraud: Why it Pays do the Right Thing

A Florida hospice provider has officially agreed to pay $1 million to settle a Florida False Claims Act lawsuit brought by two former employees.  The two employees, Heather Numbers and Greg Davis, contend that non-profit hospice provider, Hernando-Pasco Hospice Inc., defrauded the U.S. government by submitting false claims for Medicare and Medicaid services that were either never given or unnecessary.  Numbers and Davis also allege that the hospice provider knowingly provided services to ineligible patients in order to receive government funds.  As compensation for information they have offered regarding the fraud, the two former hospice employees will receive a collective sum of $250,000 to be split evenly.

New York State also has a False Claims Act that enables citizens to bring a lawsuit on behalf of the State of New York against those who have defrauded the state or local government. This Act not only protects those who blow the whistle from employer retaliation, but it also provides monetary rewards to the plaintiff(s) if the government intervenes in the case and funds are recovered. Depending on the extent that the plaintiff assisted the government in the prosecution of the wrongdoer, the plaintiff is entitled to keep between 15-25% of proceeds recovered through litigation or settlement. If the government chooses not to pursue a claim, the plaintiff may pursue the action independently. If successful, the plaintiff is entitled to keep between 25-30% of proceeds recovered. Usually, this reward is no small sum.

Medicare and Medicaid fraud is rampant in Brooklyn because of the borough’s high density of healthcare providers and the pervasive nature of the fraud more generally.  New York City administers federal benefits of this nature to millions, far more than any other city in the United States, so the opportunity for fraud is high.

If you have been terminated from your healthcare job because of your refusal to participate in Medicare or Medicare fraud or if you are aware of fraudulent claims being made in your workplace, contact an attorney who can assist you in bringing claims under the New York False Claims Act.  Being a whistleblower is never easy – more than any other form of litigation, whisteblowing can bring torment to your life – but if the matter relates to Medicare or Medicaid fraud, given the heightened focus on these particular causes of action, you will likely receive more support than usual, and possibly a financial payment for your efforts.  

Christopher Davis is an experienced employment litigator specializing in class actions, overtime wage recovery, discrimination, whistleblower retaliation, and Wall Street bonus disputes. Before entering private practice, Mr. Davis served as an Assistant District Attorney in the Manhattan District Attorney's Office where he prosecuted violent crimes as a member of the Sex Crimes Unit.

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