Medicare and Medicaid Fraud

Kohn, Kohn & Colapinto Has A Proven Track Record Assisting Whistleblowers With Medicare Fraud Claims

Kohn, Kohn & Colapinto successfully represented whistleblower Daniel Richardson against his employer, Bristol-Myers Squibb.

The corporation was accused of illegally marketing drugs and, as a result, caused an increase in Medicare and Medicaid costs paid for by taxpayers. KKC represented Mr. Richardson in a qui tam fraud action against the drug maker and was able to recover $515 million for U.S. taxpayers and the government. Mr. Richardson received a multi-million dollar reward or “relator share” for his contributions serving the public interest.


Medicare and Medicaid Fraud means a medical provider – doctor, dentist, hospital, hospice care provider or nursing home – makes a fraudulent reimbursement claim. The most common types of Medicare or Medicaid fraud include: billing for unnecessary procedures or procedures that are never performed; for unnecessary medical tests or tests never performed; or for unnecessary equipment.

Company found guilty of Medical fraud
Medicare or Medicaid Fraud violates the False Claims Act. The False Claims Act is 31 USC § 3729-3733. The qui tam provisions of the False Claims Act allow persons and entities with evidence of medicare fraud against federal programs or contracts to sue the wrongdoer on behalf of the United States government. In qui tam actions, the government has the right to intervene and join the action. If the government declines, the private plaintiff may proceed on his or her own.

Violators of the False Claims Act are liable for three times the dollar amount that the government is defrauded and civil penalties of $5,000 to $10,000 for each false claim. A qui tam plaintiff can receive between 15 and 30 percent of the total recovery from the defendant, whether through a favorable judgment or settlement. To be eligible to recover money under the Act, you must file a qui tam lawsuit. Merely informing the government about the violation is not enough. You only receive an award if, and after, the government recovers money from the defendant as a result of your suit.

If you have knowledge of Medicare or Medicaid Fraud and need a whistleblower advocate to help you with your case, please contact us.

For more information, see our resource page on the False Claims Act or visit the Kohn Kohn & Colapinto Blog