A whistleblower is someone who has knowledge that a person or organization is engaged in an unlawful activity. In healthcare, whistleblowers often are employees of a healthcare organization or practice. However, they also can be patients. These cases are brought under the False Claims Act (FCA).
A whistleblower who has knowledge of healthcare fraud or false claim can bring a lawsuit or qui tam action against the offending provider. After investigating the whistleblower’s allegations, the government can decide to intervene in the case, reserve the right to intervene at a later time, or pass. If the government decides not to intervene, the whistleblower or “relator” can proceed with the action on his own.
In cases where the government intervenes, the relator shares in the proceeds of any successful litigation or settlement.
Whistleblowers are protected and if they are fired or suffer negatively as a result of filing a qui tam action, they may have a case for unlawful retaliation under the False Claims Act. A successful case could result in your receiving double the amount of your backpay, as well as compensation for other damages, along with your share in the recovery of the initial qui tam action.
There have been numerous cases in which whistleblowers have been awarded millions of dollars as a result of their bringing cases of fraud and abuse to the attention of the government. On the flip side, untold numbers of healthcare providers and organizations have become the target of whistleblower actions as a result of their illicit activity.
Such activities can include, but are not limited to:
- Providing unnecessary medical care and treatment
- Fraudulent billing, i.e. billing for services not provided, overbilling, etc.
- Receipt of kickbacks
Whistleblower cases are highly complex and require the knowledge and skill of an attorney who has extensive and relevant experience. The Health Law Offices of Anthony C. Vitale is known for its representation of whistleblowers, as well as its ability to defend those who become the target of a whistleblower action.