Everything you wanted to know about being a Whistleblower

Whistleblowers have courage and integrity. They help combat fraud in many ways. Whistleblowers who successfully report Medicare & Medicaid fraud under the False Claims Act (“FCA”), securities law violations as an SEC whistleblower, and tax fraud as an IRS whistleblower have generated awards of hundreds of millions of dollars through the use of an experienced whistleblower law firm. Whistleblowers may also report private insurance fraud in California and Illinois and tax fraud in New York.

What is considered Medicare & Medicaid Fraud?

Medicare fraud occurs when an entity systemically puts in for Medicare money it is not entitled to, fails to return improperly received funds, engages in self-dealing, and/or pays kickbacks to obtain Medicare patients.  Medicaid Fraud is the same unlawful conduct as Medicare fraud, but generally implicates the state Medicaid programs. A good rule of thumb in the healthcare space is to properly report any suspicious or fraudulent activity by using a whistleblower law firm to protect the integrity of the system, patient welfare, and taxpayer dollars. The most common forms of Medicare & Medicaid Fraud are:

  1. Billing for services not rendered
  2. Kickbacks and self-dealing
  3. Upcoding and billing for unnecessary services or items
  4. Provider enrollment and accreditation fraud
  5. Pharmaceutical & FDA fraud

Visit our Medicare & Medicaid Fraud page to learn more.

How do I report Medicare & Medicaid Fraud as a Whistleblower?

Medicare & Medicaid fraud claims are brought under the False Claims Act (“FCA”), which allows anyone with a whistleblower attorney and evidence of fraud to bring a lawsuit on the government’s behalf.

Brown, LLC has a whistleblower division led by Jason T. Brown, a former FBI Special Agent and Legal Advisor.  Our team has recovered tens of millions of dollars for the government and significant whistleblower awards for our clients. Because the whistleblowing process is complex and rife with pitfalls, it is essential to have a trusted lawyer by your side who can direct a thorough investigation and help you present the strongest case to the government. 

How much are the Average Whistleblower Awards?

Medicare & Medicaid whistleblowers receive hundreds of millions of dollars each year for exposing unlawful activity, on top of saving lives and taxpayer money. Under the FCA, an intervened whistleblower case can result in an award of around 20% of the total recovery, with an average settlement of around $13 million dollars. If the Medicare fraud whistleblower proceeds and succeeds without the government’s intervention, the  whistleblower award can be between 25% to 30% of the total amount recovered.

The whistleblower lawyers at Brown, LLC work hard to maximize your whistleblower award if successful, because the firm is only paid if you win your case.  

Will I lose my job if I report Medicare & Medicaid Fraud?

The law has very rigorous mechanisms to prevent you from losing your job as a whistleblower under the False Claims Act for Medicare Fraud. But you must blow the whistle in the right way. Also, even though the company is not supposed to retaliate, it may illegally try to do so, it may conduct a mole hunt when they are alerted there is a whistleblower and may act in other unconscionable ways to make life more difficult.  

Is there a time limit to file a Medicare & Medicaid Lawsuit?

Yes, there are strict timelines for filing whistleblower lawsuits, and it could be a very short time. Furthermore, only the first whistleblower to file is entitled to a whistleblower award. You are not only racing against the clock, but also against other potential whistleblowers. The below video featuring former FBI Special Agent Jason T. Brown, the head of Brown, LLC provides more details about the first to file rule:

Why Consult Brown, LLC?

Brown, LLC has a track record of success with litigation nationwide and is passionate about protecting the whistleblowers. There are numerous reasons to consult them.

First, the consultation is free and confidential and we are only paid if we win your case. 

Headed by Former FBI Special Agent

Jason T. Brown, the head of the whistleblower law firm, is a former FBI Special Agent and Legal Advisor. These cases often require interfacing with the United States Attorney’s Office, and he has extensive experience doing so.

You Owe Nothing Unless We Win

Brown, LLC is only paid if we win your case.

That means:

  1. You don’t pay anything up-front.
  2. If the case is lost you don’t owe the firm anything. 

We Handle Cases Nationwide

Our whistleblower operations cover the entire United States. We handle cases nationwide, in conjunction with local counsel, and will travel to you if needed.

We PROTECT Whistleblowers

We are aware of the risk of retaliation a Medicare whistleblower faces from the healthcare industry; despite all the protection provided by the whistleblower law. We work with you to maintain anonymity first and a strategy to help cushion any actual or perceived retaliation.

We PROTECT Whistleblowers

The First to File Rule means the first person to file can obtain a recovery if the case succeeds, the second obtains nothing. Time is of the Essence, Act Now.

The First to File May Receive A Considerable Award

In 2016, there were over $500 Million awarded to whistleblowers under the False Claims Act. We at Brown, LLC have a track record of nothing but success.

Additional Whistleblower FAQs

How do I know if I qualify as a whistleblower?

A whistleblower must have concrete information about fraud based on personal knowledge and evidence — not from public sources like the internet or the news.  To understand whether you can qualify as a whistleblower under the False Claims Act or other statutes you should speak with a whistleblower law firm like Brown, LLC.

Reporting what other types of fraud can generate whistleblower awards?

– Securities fraud takes place when companies seek to manipulate stock prices by, among other things, making false and misleading statements to investors, or in their filings with the Securities and Exchange Commission (SEC) or put the best interest of the client after their own economic interest by insider trading, churning accounts, excessive fees, failure to give best pricing or other fraudulent behavior. With the use of an SEC whistleblower lawyer you can potentially remain anonymous from start to finish.

– Commodities fraud is addressed through the Commodity Futures Trading Commission (“CFTC”) Whistleblower Program, which targets manipulations of commodity futures, options, and swaps that harm investors and consumers. If you know of abusive or deceptive conduct by banks, financial firms, and other entities involved in the sale and exchange of derivatives and other financial instruments, you may be entitled to a significant whistleblower award.

– Tax fraud can be reported to the IRS if you have credible information that an entity or individual is knowingly not paying federal taxes. If the value of the underpayment exceeds $2 million, you may be entitled to a portion of the amount collected. Additionally, if the tax fraud occurs in New York, the New York False Claims Act permits whistleblowers to  privately sue on behalf of the government those who knowingly fail to pay state taxes.

– Money laundering occurs when money is routed through banks and  other financial entities and conceals the source of those funds. The recently-enacted Anti-Money Laundering Act awards whistleblowers up to 30% of the proceeds recovered in any judicial or administrative proceeding against a financial institution, business or other entity committing money laundering.  One example of money laundering is in the cannabis industry, where banks and other entities have held or routed proceeds of marijuana sales, which, although legalized in some states, remain illegal under federal law.

Some example of actionable vs non-actionable whistleblower cases:

Actionable: You have insider knowledge that a hospital is providing kickbacks to non-employees in exchange for incoming referrals of Medicare or Medicaid patients. This is actionable under the False Claims Act and the Anti-Kickback Statute.

Non-Actionable: Your neighbor is receiving Medicare benefits despite not being eligible. This is not actionable under the False Claims Act because it is too particularized with no evidence of systemic Medicare fraud. The conduct may still be criminal, but is unlikely to lead to a whistleblower award under the FCA.