Whistleblowers Help U.S. Save Taxpayer Dollars

Qui Tam Medicare/Medicaid Fraud Cases On The Rise

Every year, billions of taxpayer dollars are lost to fraud in federal and state health care programs. According to a Government Accountability Office (GAO) report released on March 13, 2009, Medicare spending on home health was $12.9 billion in 2006, which is 44% increase since 2002. What contributed to this rise in Medicare spending for homebound enrollees? Upcoding by home health agencies as well as other fraudulent and abusive practices, such as kickbacks and billing for services not rendered, said the GAO report.

To stop this type of fraud, the U.S. government passed the False Claims Act. Under the False Claims Act, any contractor that has knowingly presented a false claim for payment to the United States is committing fraud. The False Claims Act provides huge financial incentives to citizen whistleblowers to retain attorneys and come forward, prosecute these lawsuits and fight government fraud. That is called Qui Tam litigation. In Qui Tam litigation, a private citizen (the whistleblower) who knows of fraud committed against the government may, through his own privately retained lawyers, file a law suit to recover the losses caused by the government fraud. Since the early 1990s, a growing number of cases have been filed as a result of fraud against government medical health insurance programs, including Medicare, Medicaid and Tri-Care (Military).

A major concern that people have in coming forward to report when fraud is being committed at their place of employment is that they fear retaliation and retribution. But the False Claims Act provides employment protections for whistleblowers. If an employee is fired, demoted, harassed, or otherwise discriminated against for filing a False Claims Act suit, the law provides for reinstatement, double back pay, and compensation for special damages, including litigation costs and reasonable attorneys’ fees.

If you or someone you know has questions or concerns regarding Qui Tam please call today at (800) 555-4011 for your free consultation, or you can contact us here.