Healthcare Whistleblower Lawyers File Claims Under the False Claim Act
The False Claims Act, also called the FCA (or sometimes the Lincoln Law), exists for different reasons. Its purpose is to encourage people to come forward when they encounter fraudulent activity by their employers against the government.
The FCA protects “whistleblowers” from employment-related retaliation to aid in this purpose. The FCA also helps encourage whistleblowing by allowing individuals to file FCA claims on the government’s behalf.
At Alonso Krangle, LLP, our lawyers represent clients who are whistleblowers. If you face retaliation for coming forward with claims of fraud, we can hold your employer responsible for violating your rights under the Fair Claims Act. We can also help you file a qui tam claim on behalf of the government.
Our healthcare whistleblower lawyers have experience handling all types of FCA and qui tam lawsuits related to fraud against the government. Let Alonso Krangle, LLP help you collect the maximum damages allowed by law. Call (800) 403-6191 today for a free case evaluation.
What is Fraud Against the Government?
For the purposes of the False Claims Act, fraud means submitting false claims to the government. It is essentially attempting to get payments from the government for fraudulent reasons. The FCA makes it illegal to submit false claims to the government.
Some examples might include a government contractor submitting invoices for work not performed or a doctor submitting claims to Medicare for patients they never treated.
Fraudulent Claims in the Healthcare Industry
Some of the biggest fraud cases involving false claims against the government are in the healthcare industry. Medicare and Medicaid fraud occurs in different ways and occurs often. Consider the ways Medicare fraud and Medicaid fraud take place:
- Diagnostic imaging centers ask for reimbursements for tests not performed
- Companies overestimate clinical costs and submit claims for reimbursements
- Doctors submitting claims for visits not performed and tests not done
- Forcing patients to undergo unnecessary tests and seeking reimbursement
- Performing unauthorized testing on patients and filing claims for reimbursement
Submitting false claims to Medicare or Medicaid is illegal and impacts the taxpayers who fund these insurance plans. Medicare and Medicaid fraud are often uncovered thanks to whistleblowers who want to stop the unlawful behavior. Coming forward can lead to the recoup of millions of dollars for the government and, therefore, the public.
Individuals or businesses that violate the FCA by submitting fraudulent claims to the government can be liable for three times the government’s damages. They can also face civil penalties of at least $5,00 for each false claim.
How Can the FCA Protect You as a Healthcare Whistleblower?
Do you work in a hospital? A federally funded nursing home? A doctor’s office? How can you protect yourself from adverse consequences if you have evidence that your employer is submitting false claims?
The False Claims Act provides very specific protection for health care workers who discover their employer is filing false claims. Given how prevalent Medicare provider fraud is, if you work in health care, you should understand how the laws protect you.
Most importantly, the FCA protects whistleblowers from retaliation in the terms and conditions of their employment. This protection is critical to encourage employees to speak up and report it to their superiors when they suspect their employer is filing fraudulent Medicare or Medicaid claims.
The law states the whistleblower may not be “discharged, demoted, suspended, threatened, harassed, or in any manner discriminated against in the terms and conditions of employment because of lawful acts done by the employee in furtherance of an action” under the FCA.
An employer cannot retaliate if you report fraud to your supervisor or HR department, take steps to investigate suspected fraud, or try to stop the fraud.
If you do experience retaliation, the FCA gives you an opportunity to file a retaliation lawsuit.
Whistleblowers Can File Retaliation Claims
If you experience retaliation after uncovering or reporting Medicare fraud, you might be able to file a retaliation claim.
You will have to demonstrate:
- You engaged in lawful activity in furtherance of an FCA action
- Your employer knew about the activity
- Your employer exercised retaliation against you because of it
If you can prove these things, you might be entitled to relief and damages. For example, if your employer fired you, you could receive reinstatement. If your employer denied your promotion in retaliation, you could be promoted immediately.
You might also receive two times your lost back pay, interest on the back pay, and compensation for other damages sustained. Other damages could include attorney’s fees and litigation costs.
Medicare Fraud Whistleblowers Can Also File Qui Tam Claims
Under the False Claims Act, whistleblowers are granted the authority to file qui tam claims.
A qui tam claim is a lawsuit for FCA violations brought by an individual on behalf of the government. The person who brings the action-the whistleblower- is called a “relator.”
The government may or may not join in the lawsuit.
If the relator proves fraud, the court orders the defendant to pay damages to the government. The relator is entitled to collect a percentage of those damages. In a successful qui tam case, the whistleblower is entitled to 15-30% of the amount awarded to the government, plus legal fees.
For example, if the court orders a doctor to pay $100,000 to the government for FCA violations, the whistleblower could receive $15,000-30,000 for reporting the fraud.
Call Alonso Krangle if You Find Fraud
Consider some questions:
- Do you work in a medical office, a physical therapy center, or a nursing home?
- Is someone filing Medicare claims for patients or clients you aren’t treating?
- Is someone inflating the costs of services you are providing?
- Is someone ordering unnecessary tests to file more claims?
- Are you afraid to speak up about your concerns?
- Are you worried about your job if you do?
If you are dealing with some of these concerns, call our whistleblower lawyers at Alonso Krangle, LLP. We can help you navigate the process of bringing a qui tam claim and, if necessary, enforce your rights under the no-retaliation clause of the FCA.
We know you understand the importance of stopping Medicaid and Medicare fraud and your desire to see that justice is served. We also understand that you have a job to consider. Let our lawyers review your case, lay out your options, and help you reach a resolution that can have benefits for you and the public.
Call our whistleblower lawyers today at (800) 403-6191 for your free consultation.