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I Think My Company Is Committing Healthcare Fraud. What Should I Do?

August 14, 2023

Imagine finding yourself employed in a healthcare setting where you are committed to helping patients, but you start noticing unethical practices, such as billing fraud against Medicare or Medicaid. All too often the health care provider engages in practices such as overbilling and then  taking advantage of Medicare.  Sometimes, kickbacks are involved and you’re starting to wonder whether the encounter was actually for the patient or just for the billing.. You feel torn between your dedication to patient care and the disturbing reality unfolding before you and its consequences to your future employment. This blog will guide you through your options, but if you prefer to speak with a health care law firm that represents whistleblowers and goes over their options, call us at (877) 561-0000 for a free, confidential consultation. 

Understanding the Dilemma:

Witnessing healthcare fraud can be emotionally challenging. You may feel a sense of guilt and betrayal, as the actions of a few threaten the reputation and integrity of your workplace.  You may on the other hand wonder how reporting the conduct may have consequences to you and if so, is there actually an upside other than knowing you’re doing what’s right. 

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Confronting Medicare Fraud:

When facing a dilemma about reporting Medicare Fraud, or other health care fraud versus keeping quiet, your choices are limited::

  1. Stay Silent: Remaining silent may seem easier, but it perpetuates the fraud and compromises patient safety. Moreover, your silence may inadvertently implicate you in the fraudulent activity. At some point, someone might blow the whistle on the fraud and when the investigators start asking questions they may want to know why you went along with the fraud which could have licensing implications.  
  2. Report Internally: You can voice your concerns to your superiors or human resources department. However, this approach generally leads to very negative consequences with the company viewing you as part of the problem. The company may have attorneys interviewing you repeatedly and the attorneys work for the company not for your interest.  This route can ironically lead to your termination and lead to the company looking for reasons to blame you for the fraud.
  3. Seek Legal Whistleblower Counsel: Consulting with a whistleblower attorney who is familiar with healthcare fraud cases can be extremely beneficial. They will confidentially advise you of your rights, and educate you about potentially filing a claim through the False Claims Act if Medicare or other government funds are implicated. Each year whistleblowers receive hundreds of millions of dollars in whistleblower rewards for doing the right thing, but it must be done correctly.

How Whistleblowers Make a Difference

Whistleblowers are critical in the fight against healthcare fraud. They protect the integrity of the healthcare system, patients, and taxpayer funds by exposing fraudulent practices. Their brave actions spark systemic change, discourage potential future fraudsters and encourage accountability for the greater good of society. Regardless of the obstacles they may face, whistleblower protections exist to protect their rights and ensure that they can make a difference with confidence.

Seek Help from a Healthcare Fraud Whistleblower Attorney

Exposing healthcare fraud is an essential step towards maintaining the integrity of the entire industry.. Knowing where to turn and who to trust in your time of need is important – you should reflexively have someone you can confide in that’s in your corner.

In such circumstances, seeking help from a whistleblower attorney experienced in fighting healthcare fraud is of paramount importance. These seasoned legal professionals specialize in handling whistleblower cases and possess the proficiency needed to navigate the complexities of such matters. By enlisting the support of a whistleblower attorney, you may gain a trusted advocate who will advance your case and make sure your rights are upheld throughout the entire process.

Fighting Healthcare Fraud Under the False Claims Act

The False Claims Act offers a powerful tool for combating healthcare fraud through qui tam lawsuits when the healthcare fraud is against the government programs such as Medicare, Medicaid or Tricare. These qui tam lawsuits, filed by private individuals on behalf of the government, are kept under seal, ensuring confidentiality during the initial stages of investigation. If the case leads to a successful recovery, the whistleblower is entitled to receive a portion of the funds recovered by the government as a whistleblower award which can be up to 30% of the recovery.

Empowering Whistleblowers in Qui Tam Lawsuits

While qui tam lawsuits can take years to resolve, they empower employees to stand up against fraud and reap substantial rewards for doing the right thing. In one year alone, the U.S. Department of Justice recovered $3 billion in qui tam cases and rewarded whistleblowers with roughly $435 million in whistleblower rewards

Protection Against Retaliation for Whistleblowers

Fear of retaliation is a common concern for whistleblowers. However, the federal False Claims Act protects individuals from employer retaliation. It is illegal for an employer to discharge, demote, suspend, harass, or discriminate against a whistleblower in any way as a form of retaliation. If retaliation occurs, the law allows the whistleblower to seek compensation in a court of law, including reinstatement, back pay with interest, court costs, attorney fees, and special damages.

Choose a Dedicated Whistleblower Law Firm

We have a focus of our practice in representing False Claims Act whistleblowers. The whistleblower law firm of Brown, LLC takes almost all whistleblower matters on a contingent fee basis, meaning you pay nothing unless we succeed in your qui tam case and then our fee is taken from the recovery and/or we have the defendant pay it. If you have discovered healthcare fraud within your company, don’t hesitate to contact us for a free, confidential consultation. Our experienced False Claims Act lawyers are committed to providing professional counsel and support to whistleblowers who have bravely chosen to do the right thing.