New York City Whistleblower Attorneys for Healthcare Fraud

At Schwartzapfel Lawyers P.C., we represent individuals who have information about healthcare providers who are submitting false claims for payment to the government. If you have this type of information, it is important that you come forward. Our lawyers can help you understand your situation and, if appropriate, pursue a whistleblower claim under the False Claims Act.

Common Forms of Healthcare Fraud

In order to receive federal funding, hospitals, private medical practices, and other healthcare providers are required to submit a variety of records and reports to the government. These records and reports are supposed to be accurate. Unfortunately, many healthcare providers know that the government does not have the expertise and resources necessary to verify all of the payment claims it receives. As a result, they intentionally submit false claims – and receive billions of dollars in unjustified payments every year.

Some of the ways in which healthcare providers obtain unjustified payments from the government include:

  • Billing for services that were never provided
  • Performing and billing for unnecessary services
  • Filing false or misleading cost reports
  • Mischaracterizing reimbursable costs
  • Submitting falsified records to the government
  • Offering or accepting kickbacks

While the government’s efforts to combat false claims are effective – for every $1 spent it recovers $7 from false claims – it is simply unable to investigate the vast number of false claims that get filed every day. This is why the government relies on individual whistleblowers to help identify fraudulent activities to go after.

Who Commits Healthcare Fraud?


Due to their size and the number of patients they treat on a daily basis, hospitals are some of the biggest offenders when it comes to healthcare fraud. Hospitals in New York and throughout the country have been successfully sued for false claims ranging from “upcoding” treatments to billing for tests and treatments that were not actually provided.

Private Medical Practices

Private medical practices often get into trouble for upcoding and other forms of overcharging. Several private practices have been held liable for tens of millions of dollars in fraudulent charges arising out of improper billing practices and unnecessary medical procedures.

Nursing Homes and Hospices

Nursing homes, hospices, and other long-term care facilities regularly face whistleblower claims for improper billing practices, falsifying treatment records, and charging for unnecessary medications and care. Like hospitals and private practices, these facilities can also get into trouble for various forms of Medicare and Medicaid fraud.

Home Healthcare Providers

Home healthcare is becoming an increasingly popular option for patients who prefer not to live in long-term care facilities. Unfortunately, as these providers get more work, they are also finding more opportunities to engage in healthcare fraud. Some home healthcare providers have been found liable for involvement in kickback schemes as well.

Medical Laboratories

Medical labs commit healthcare fraud in a number of different ways. Some of the most common include using misleading forms to cause doctors to order unnecessary tests, unbundling tests to bill additional fees, falsifying records, and charging for tests that were never performed.

Ambulance Operators

Ambulance service companies can be sued under the False Claims Act for practices such as providing unnecessary services to patients who can transport themselves, offering kickbacks, and participating in Medicare and Medicaid fraud.

Who Can Report Healthcare Fraud?

Any private citizen can report healthcare fraud and file a claim under the False Claims Act. If you have evidence of a fraud that has been committed against the government, Schwartzapfel Lawyers P.C. can conduct an assessment and, if appropriate, help you file a whistleblower claim.

In healthcare fraud cases, whistleblowers are commonly:

  • Patients
  • Family members of patients
  • Employees of healthcare providers engaged in fraudulent activity
  • Contractors working with healthcare providers engaged in fraud

As an employee or contractor, the False Claims Act protects you against retaliation for filing a whistleblower claim. In short, a company cannot fire you or end your contract because you reported a false claim. If they do, you are entitled to financial compensation – including double back pay, interest, attorneys’ fees, and other damages.

Contact Schwartzapfel Lawyers P.C. about Your Healthcare Whistleblower Claim

If you believe that you may have evidence of healthcare fraud, Schwartzapfel Lawyers P.C. can help you pursue a claim under the False Claims Act. Our attorneys have decades of experience fighting for New York residents, and we can make sure that you receive just compensation for your whistleblower claim. To schedule a free consultation, please contact us today.

All communications with Schwartzapfel Lawyers P.C. are completely confidential, and there is no fee unless we win your case.