The Visiting Nurse Service of New York (VNSNY), one of the largest home healthcare companies nationwide is facing a lawsuit accusing the company of committing massive Medicare fraud against the government.

The whistleblower lawsuit was brought forth by the former Vice President of Operations Improvement and Integration, Edward Lacey, who serves as the relator, or whistleblower, in this case.

The former employee accused VNSNY of engaging in massive Medicare fraud and Medicaid fraud by extracting hundreds of millions of dollars illegally from the government.

More than 150,000 patients are served each year in New York by VNSNY, a nonprofit organization that provides rehabilitation therapy, skilled nursing care and behavioral health therapy to eligible patients within the comfort of their own homes.

Massive Medicare Fraud Allegations

The lawsuit brought forth by Lacey under the False Claims Act states that the home healthcare company illegally billed both Medicaid and Medicare for services it did not provide or improper services, as well as shortchanged patients out of appropriate care that was directed by their physicians.

The massive Medicare fraud lawsuit was initially filed by Lacey in 2014 in New York federal court and was under seal until September of this year.

During the time between the initial filing and the opening of the seal, federal and state authorities have been confidentially investigating the case.

The lawsuit alleges that VNSNY “intentionally ignored” the care plans established by physicians for their patients and provided only a small portion of the visits that patients were billed for under Medicare for nursing and rehabilitation services, all for the home healthcare agency to receive financial gain.

The massive Medicare fraud lawsuit also alleges that VNSNY engaged in falsifying service records for hundreds of employees of the company who worked as nurses and therapists.

The allegations also state that VNSNY billed for the services of home health aides that were never provided or the services were improperly supervised.

Apparently, this is not the first time the Visiting Nurse Service of New York has been investigated for potentially illegal activities. The facility has been the target of numerous audits recently, as well as investigations.

Legal action has also been taken against VNSNY in the past. In 2013, the facility was required to pay $33.6 million to Medicaid after it was found that the agency enrolled ineligible patients for its program providing adult day care services.

Filing a Whistleblower Lawsuit over Massive Medicare Fraud

If you have witnessed massive Medicare fraud, Medicaid fraud or government contractor fraud against the government, you may be eligible to file a whistleblower lawsuit under the False Claims Act.

It is important to note that whistleblowers who aid the government in recovering large amounts of money may be eligible to receive 15 to 30% of the amount of money recovered in a whistleblower lawsuit. These amounts can be substantial, ranging from $75,000 to more than $50 million in some cases.

However, whistleblowers who report through a whistleblower hotline or who report directly to their employer are not covered under the False Claims Act and may be ineligible to recover a portion of a monetary award and may not have the same whistleblower protection provisions.

It is important to consult with an experienced whistleblower attorney, and you may do so for free if you qualify. An attorney can review your case free of charge and discuss a plan for taking legal action with you.