Health care workers such as nurses, technicians and assistants may blow the whistle on their employers. If you discover someone at work breaking the law or asking you to cover up misconduct, you may choose to file a qui tam lawsuit.
The United States Department of Justice reports that health care fraud in 2021 resulted in more than $5 billion in settlements. Whistleblowers in the medical field initiated over 500 lawsuits under the False Claims Act. These actions revealed rampant fraud enacted against the federal and state governments.
What types of frauds occur in the health care industry?
False Claims Act settlements from 2021 included matters relating to hospitals, hospices and device manufacturers. Employees helped combat fraud by blowing the whistle on doctors and managed care providers engaged in deception. Pharmacies and drug manufacturers also faced legal actions over their misconduct.
The U.S. Department of Health and Human Services notes that employees should report waste, fraud and abuse. If you find duplicate billing statements or unwarranted expenses, you may report them as contract fraud. Common forms of abuse include falsifying records or using government funding to buy personal items.
What may happen when employees file a qui tam claim?
According to the DOJ, an effective qui tam action may result in the whistleblower receiving a portion of the settlement. Whistleblowers generally receive payments worth 15% or 30% of the settlement amount.
Section 3730(h) of the False Claims Act prohibits employers from retaliating against whistleblowers. Your employer may not harass, fire or demote you for outing unlawful activities. Employees file claims to help their patients and to prevent medical professionals from cheating the public system.
Because taxpayers’ funds pay for Medicare and other public health benefits, the law protects whistleblowers. Whether you find inappropriate prescriptions or kickbacks between practitioners, a qui tam lawsuit could help prevent continued misconduct.