When employees, workers or even board members witness wrongdoing on a company’s part, it is important to know their actions to report it have protections. There is not much incentive to blow the whistle on something if all it does is get people fired.
In a qui tam case, a whistleblower assists the government in launching an investigation that leads to recovering misspent funds.
Medicare and Medicaid billing in New York
As The Palladium-Times reports, a company called Oswego Health has cooperated in a federal and state investigation. A whistleblower, confirmed as a former employee, filed a complaint alleging the company and its hospital of knowingly violating the False Claims Act. The United States Department of Justice eventually alleged the company of improperly billing Medicare and Medicaid outpatient mental services.
Despite annual audits and reviews to ensure compliant practices, government investigators found enough to make other allegations. They found that licensed master social workers rendered mental health services while unsupervised.
In order to settle these allegations, Oswego Health agreed to pay more than $98,000. As part of the qui tam complaint, the whistleblower received over $19,000 of the settlement for the reporting.
Qui tam anywhere in the country
State and federal government regulators and investigators do not have the workforce to monitor every company. When private citizens assist in recovering mishandled government funds, they may get to share in as much as 15 to 25 percent of the funds recovered. Any whistleblower should investigate further into his or her case to see whether a complaint falls under the False Claims Act.