How to Anonymously Represent a Medicare Fraud as a Whistleblower and Receive a High Reward Too

by Leslie Reynolds FIGHT FOR RIGHT

The most common types of Medicare and MedicAid frauds committed by healthcare industry professionals such as hospitals, doctors, pharmacies, nurses, primary caregivers, drug manufacturers, etc. include billing for unnecessary procedures or the procedures that were never performed, or ordering for unnecessary medical tests or equipment. Other cases of Medicare and MedicAid frauds include nursing home abuses, billing for services provided to ineligible persons, paying kickbacks to caregivers to prescribe certain drugs, knowingly presenting a fraudulent or false claim, submitting a false statement to conceal or decrease an obligation to pay money to the federal or state government, overcharging at pharmacies, conspiring with others to make a false claim under the Medicare or MedicAid program, etc.

Whistleblower claims

Whistleblower reward laws such as the False Claims Act (FCA) have proven to be instrumental in combating fraud in the healthcare industry. There are now more than 600 new whistleblower or qui tam cases annually in the USA. Violators of FCA are liable for three times the dollar amount they defraud the government with through Medicare and MedicAid frauds, plus penalties of $5,000 to $10,000 for each false claim. Each individual invoice submitted to a government healthcare program is considered as a separate false claim and processed accordingly. As a qui tam whistleblower, you stand to win anything from 15% to 30% of the total recovery by the government in addition to the legal fees and costs. Non-US citizens can also receive rewards under the False Claims Act. Recently, a California-based mobile lab and X-ray provider agreed to pay $17.5 million to the whistleblower to settle the allegations of violating the federal and state government’s Medicare programs, for paying kickbacks.

Brown LLC’s best whistleblower lawyers have a long-standing of successfully representing whistleblower cases and assisting the whistleblowers with hundreds of millions in rewards through qui tam settlements and judgments.

Who can be a whistleblower?

However, merely reporting Medicare fraud to the government is not enough. More important is to know how to report Medicare fraud the correct way as you receive your reward only if the government is able to recover money from the defrauder as a result of your qui tam suit. In Medicare and MedicAid fraud cases, the whistleblower must work with an attorney to file a lawsuit against the violator.

Medicare and MedicAid fraud cases are challenging as the government requires strong evidence from the whistleblower. Any person with evidence of fraud against a government healthcare program can be a whistleblower. Many whistleblower cases are brought by the people close to the source of fraudulent activity, such as employees, suppliers and vendors. These people reporting Medicare fraud have the best chances to win a qui tam case as they have intimate knowledge of a particular fraudulent scheme.

Protecting your rights as a whistleblower

A variety of whistleblower protection laws are in place such as the Whistleblower Protection Enhancement Act, Dodd-Frank Act and Consumer Product Safety Act. Under Section 3730(h) of the False Claims Act, if an employee is discharged, demoted or harassed or otherwise discriminated against by the employer is entitled to all relief to make them whole employee, such as reinstatement, double back pay, and compensation for any damages. Brown LLC’s top whistleblower lawyers will ensure that you are protected from all retaliatory actions by your employer for reporting Medicare fraud. HIPAA’s (Health Insurance Portability and Accountability Act) Privacy Rule allows individuals to disclose protected health information to a health oversight agency or an attorney as long as that information pertains to professional misconduct. Not surprisingly, this important HIPAA rule is not widely publicized by the healthcare industry.

Considering blowing the whistle on Medicare fraud?

Brown LLC’s Medicare fraud lawyer will find a qui tam case on your behalf, keeping your identity confidential during the government’s investigatory process. However, once the case is settled or dismissed, it may become a matter of public record. The law firm’s best whistleblower attorneys will help you in filing your qui tam case under seal in federal district court in accordance with the Federal Rules of Civil Procedure. The action under FCA will be filed in camera and under seal. Your identity and content will be kept confidential until the seal is lifted.

Don’t go it alone

Under the “first to file” rule, you are eligible for a reward, regardless of whether or not a complaint is filed within the statute of limitations. However if the government or a private party has already filed an FCA lawsuit base on the same lawsuit as you do, you cannot bring a qui tam lawsuit. So, it is important to file the qui tam lawsuit as soon as possible. Brown LLC’s Medicare fraud lawyers will evaluate your information and documentation to find out if it qualifies for a qui tam or whistleblower lawsuit, and advise you about the further course of action. Besides whistleblower cases, Brown LLC also offers legal services for complex litigation, bad products, employment and serious injuries. For more information, please visit ifightforyourrights.com