Perhaps you work in a doctor’s office. It is a large practice with a large billing department.
You are certain there is a scheme afoot to defraud Medicare. You would like to report this to someone, but you do not want to get in trouble and lose your job. What should you do?
Reporting fraud
Knowingly presenting the federal government with a false claim for payment, using a fraudulent statement or record to obtain payment from the government or conspiring with others to do so are examples of violations under the False Claims Act. If you are aware of such fraudulent activities in the office where you work, you can file an action confidentially, under seal, in a federal district court.
False Claims Act penalties
Those found liable for False Claims Act violations face a penalty of three times the amount the government was defrauded, plus $5,000 to $10,000 in civil penalties for each fraudulent claim. As the whistleblower, you can expect an award of 15 to 30 percent of the total recovery amount. Keep in mind that you must file a lawsuit to qualify for the award, which will come your way after the government receives payment from the defendant.
An appreciative government
Medicare, Medicaid and similar targets lose billions of dollars annually because of healthcare fraud. Insider employees like you are a big help in uncovering fraudulent activities the government could not learn about on its own. A study published in the concerning financial incentives and the disclosure of corporate wrongdoing found that the process offers the most incentive for a whistleblower to share valuable information the government can use in tracking down fraudsters. Explore your legal options so you can gain a thorough understanding of actions, how the government proceeds with these confidential claims and how you can benefit.
