Medicare Whistleblower Lawyer
Get Compensation for Reporting Medicare Fraud
Medicare fraud is a pervasive problem in the United States, costing taxpayers billions of dollars every year. It’s a complex and ever-evolving issue that requires the expertise of a skilled Medicare whistleblower lawyer to help those brave enough to come forward and report fraud.
Benjamin Yormak is one of the few board-certified employment law experts in the state of Florida and he has extensive experience representing whistleblowers. In one of his cases, he unraveled a complex Medicare fraud scheme that led to a $26 million recovery. Yormak Employment and Disability Law is dedicated to assisting individuals in the healthcare industry who have witnessed fraudulent behavior by healthcare providers, medical device companies, and other entities involved in the Medicare program.
As a Medicare fraud attorney with extensive experience in healthcare fraud cases, we understand the intricacies of the False Claims Act, Stark Law, Anti-Kickback Statute, and other federal laws that govern the healthcare industry. We are committed to helping private citizens report fraud, protecting whistleblowers from retaliation, getting whistleblowers maximum compensation, and ensuring that the perpetrators of Medicare abuse are held accountable for their actions.
Medicare Fraud and the False Claims Act
Medicare fraud is a type of healthcare fraud that involves the submission of false claims to the federal government for reimbursement under the Medicare program. Some common examples of Medicare fraud include billing for medically unnecessary services, double billing, phantom billing, and falsifying records. Medicare fraud is not only limited to healthcare providers but also extends to medical providers, medical device companies, and even patients who knowingly participate in fraudulent schemes.
The False Claims Act (FCA) is a federal law that enables private citizens, known as “relators” or “whistleblowers,” to bring qui tam lawsuits on behalf of the United States government against individuals or entities that have submitted fraudulent claims for payment to federal healthcare programs, such as Medicare and Medicaid. Qui tam lawyers, such as the experienced attorneys at Yormak Employment and Disability Law, represent whistleblowers in these lawsuits.
Stark Law, Anti-Kickback Statute, and Physician Self-Referral Law
The Stark Law, also known as the Physician Self-Referral Law, is a federal law that prohibits physicians from referring Medicare and Medicaid patients to designated health services (DHS) entities with which they or an immediate family member have a financial relationship. This is intended to prevent conflicts of interest and ensure that medical services are provided based on patients’ needs rather than financial incentives.
The Anti-Kickback Statute is another federal law that prohibits healthcare providers and entities from offering, soliciting, paying, or receiving kickbacks, bribes, or other forms of remuneration in exchange for patient referrals or the provision of services reimbursable by federal healthcare programs. This law is aimed at preventing illegal referrals and kickbacks that may result in medically unnecessary services or other forms of healthcare fraud.
Both Stark Law and Anti-Kickback Statute violations can form the basis for a False Claims Act lawsuit, and qui tam attorneys, like those at Yormak Employment and Disability Law, can assist whistleblowers in reporting such illegal conduct.
Protecting Whistleblowers and Fighting Fraudulent Behavior
Our Medicare fraud lawyers understand the risks involved in reporting Medicare fraud, and we are committed to protecting whistleblowers from retaliation. The False Claims Act contains provisions that protect whistleblowers from adverse employment actions, such as termination or demotion, as a result of their participation in a qui tam lawsuit. Furthermore, successful whistleblowers may be entitled to a share of the monetary recovery obtained by the federal government in the case.
Our skilled Medicare whistleblower lawyers have represented individuals in a wide range of healthcare fraud cases, including those involving:
- Skilled nursing facilities
- Medicaid fraud cases
- Medical device companies
- Illegal referrals and kickbacks
- Unnecessary services and tests
- Billing for the same service multiple times (double billing)
- Falsifying records to justify unnecessary referralsPhantom billing for services not provided
- Fraudulent charges for services performed by unqualified personnel
- Unnecessary referrals to medical providers or designated health services
- Upcoding, which involves billing for a more expensive service than the one actually provided
Reporting Medicare Fraud: The Role of the Whistleblower
Whistleblowers play a vital role in combating healthcare fraud, as they often have first-hand knowledge of the fraudulent behavior occurring within their workplace or industry. By coming forward and reporting the fraud, whistleblowers can help recover funds lost due to fraudulent activity, protect Medicare patients from receiving substandard or unnecessary care, and deter future fraudulent schemes.
If you suspect Medicare fraud, it is important to consult with a Medicare whistleblower lawyer as soon as possible. Our experienced attorneys at Yormak Employment and Disability Law can provide guidance on the reporting process, help you gather evidence, and represent your interests in a qui tam lawsuit, if appropriate.
Rewards for Medicare Fraud Whistleblowers
One of the significant incentives for individuals to come forward and report Medicare fraud is the potential for financial rewards under the False Claims Act. Whistleblowers who successfully initiate a qui tam lawsuit may be entitled to a minimum of 15% of the funds recovered by the federal government as a result of their efforts. In cases where the recovery is in the millions, this is a very large reward for the employee who reports the fraud. For example, if the recovery was $50 million, the whistleblower could be entitled to a minimum of $7.5 million. These rewards are designed to encourage private citizens to take an active role in exposing fraudulent activity and help the government recover taxpayer dollars lost due to such schemes.
Here are some recent examples of real qui tam cases:
- Michigan-based Covenant Healthcare System and two physicians, neurosurgeon Dr. Mark Adams and electrophysiologist Dr. Asim Yunus, have agreed to pay $69 million and about $406,500 and $346,000 respectively to resolve allegations of violating the Anti-Kickback Statute, Stark Law, and False Claims Act. (March 2023)
- Spacelabs Healthcare, LLC has agreed to pay $2.5 million to settle claims of violating the False Claims Act by overcharging the Department of Veteran Affairs and Department of Defense between 2014 and 2019. (February 2023)
- BioTelemetry Inc. and its subsidiary CardioNet LLC, which provide cardiac monitoring services (including Holter and mobile cardiovascular telemetry (MCT) tests), will pay $44.875 million to resolve claims that they submitted false claims to federal healthcare programs for cardiac monitoring services that were improperly performed overseas and by unqualified technicians. (December 2022)
- Dignity Health and the Tenet Healthcare hospitals Twin Cities Community Hospital and Sierra Vista Regional Medical Center will pay a total of $22.5 million to resolve allegations that they submitted false claims to Medi-Cal in connection with the ACA’s Medicaid Adult Expansion program. (December 2022)
- Optical lens manufacturer Essilor Laboratories of America, Inc. will pay $23.8 million to California to resolve allegations that the company violated the state’s Insurance Frauds Prevention Act when it allegedly provided kickbacks and other unlawful incentives to eye care providers in exchange for these providers’ promises to send business to Essilor. The state’s action was initiated by a whistleblower complaint filed by Christie Rudolph, who will receive a whistleblower reward of approximately $11.1 million. (December 2022)
- The Florida Birth-Related Neurological Injury Compensation Association and a related entity, which were created by the State of Florida to provide compensation for the medical, rehabilitative and custodial care of children who suffered certain categories of birth-related neurological injuries, will pay $51 million to resolve a whistleblower’s qui tam lawsuit, pursued on a non-intervened basis, alleging that they fraudulently caused NICA participants to submit their healthcare claims to Medicaid rather than NICA, in violation of Medicaid’s status as the payer of last resort under federal law. The relators, Veronica Arven and the estate of Theodore Arven III, will receive $12,750,000 as their share of the recovery. (November 2022)
At Yormak Employment and Disability Law, our Medicare whistleblower lawyers are well-versed in the reward provisions of the False Claims Act and can help you maximize your potential recovery. We understand the personal and professional risks associated with blowing the whistle on fraud, and we are committed to ensuring that our clients receive the recognition and compensation they deserve for their courageous actions.
Contact Us for a Free Consultation
Yormak Employment and Disability Law is a trusted advocate for whistleblowers in the fight against Medicare fraud. With our extensive knowledge of the healthcare industry, federal laws, and whistleblower protections, we stand ready to assist you in exposing fraudulent behavior and protecting your rights as a whistleblower. If you are aware of Medicare fraud and need the assistance of an experienced Medicare whistleblower lawyer, contact our law firm today to discuss your case and explore your options for reporting the fraud.