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Healthcare compliance in the United States is incredibly important. Healthcare fraud results in billions of dollars in losses to the government from taxpayer dollars and can undermine the delivery of quality healthcare. If you suspect that your employer is committing healthcare fraud, your attorney can file a qui tam lawsuit under the False Claims Act.
At Herman Law Group, our False Claims Act attorneys are committed to providing legal representation to healthcare fraud whistleblowers and to ensuring their rights are protected. Keep reading to find out what healthcare fraud and FCA actions involve and how to proceed with reporting Medicare and Medicaid fraud.
What Is the False Claims Act?
The False Claims Act (“FCA”) is a federal law designed to penalize organizations and individuals who have submitted false or fraudulent claims to the government. Healthcare organizations that submit false claims to the government can receive significant financial penalties as well as damage to their reputation.
Under the FCA, whistleblower protection is provided for individuals who bring FCA or qui tam lawsuits against violators as well as protection for employees who notify their employer of violations of the FCA or otherwise engage in efforts to stop violations of the FCA. The primary protection provided under the whistleblower provision of the FCA is to protect against retaliation.
Not only are certain protections provided to whistleblowers, they are also entitled to receive a portion of any recovery to the government.
Healthcare Fraud and the FCA
When it comes to the False Claims Act, a significant number of claims are brought by whistleblowers in the healthcare industry. Here are some examples of common types of healthcare fraud that could result in a FCA lawsuit:
- Upcoding services
- Not returning overpayments
- Billing for substandard care
- Billing for services not provided
- Submitting claims for unnecessary medical procedures
- Paying kickbacks and violating Stark law
Steps to Filing a Healthcare FCA Claim
How do you file a claim? The good news is that there aren’t many steps involved, making this a relatively straightforward process.
- Get legal representation: The first step is to hire a national whistleblower attorney to represent you. Not only will they protect your rights, but they will help you gather evidence and review everything to ensure you have enough for a substantial claim.
- Inform the government agency: Another very important step in this process is notifying the government agency that is involved in healthcare fraud. When you do this, the correct federal authority will be able to initiate an investigation.
- Make a disclosure: For all FCA claims, you need to submit a disclosure statement to the DOJ, as this will be the foundation for your claim. It will include all of your evidence as well as additional details regarding the fraudulent activity.
How Much Money Can Whistleblowers Receive Under the FCA?
You could receive anywhere between 15% to 30% of the amounts recovered by the Government.
Contact a False Claims Act Attorney Today
If you believe that your employer has engaged in healthcare fraud, reach out to a False Claims Act attorney at Herman Law Group at 401-277-4110. The first consultation is free, completely confidential, and you don’t have to move forward unless you are ready.