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Witnessed fraud in the healthcare industry? Consider a qui tam claim

On Behalf of | May 29, 2020 | Whistleblowing |

Unfortunately, all too often those in the healthcare industry who deal with the government engage in wrongdoing. It may seem harmless at first, especially given the bigger picture. But wrong is wrong. Although your colleagues may try to mold you into accepting this behavior, you don’t have to. You know what’s right, and wrongdoing should be put to a stop.

Easier said than done, right? Especially when you’re afraid of retaliation. Reporting wrongdoing to your supervisor or the human resources department could lead to harassment, demotion, a missed promotion, a change of assignments or even termination. This is illegal and unacceptable. But you need to keep your job, so what are you supposed to do?

Defining qui tam claims

Consider a qui tam claim. The government knows that financial wrongdoing occurs on a daily basis across the country, but it really isn’t in a position to spot and stop it all. That’s where a qui tam claim comes in. Here, you can bring financial wrongdoing to the attention of the federal government. You simply file a lawsuit alleging the facts that constitute the wrongdoing, then the government joins the lawsuit. If successful, the government will take a large piece of whatever compensation is recovered, but the individual who initiates the qui tam claim can recoup up to 30% of the recovery.

So what kind of activities could qualify for a qui tam claim? A number of them:

  • Overcharging the government for goods provided
  • Using fraud to secure a government contract
  • Obtaining kickbacks in the medical field
  • Misusing federal grant money
  • Medicaid and Medicare fraud

If you have witnessed any of these illegal activities, then you should take some steps to strengthen your qui tam claim and protect yourself.

  1. Gather evidence: Gather as much documentation as you can, legally, that supports your claim. Speak to others about what they have seen and heard, making notes to yourself for future reference.
  2. Be quick: There can only be one qui tam case pertaining to a particular issue, so the first to file it is the first and only one to reap the rewards. Also, you’ll need to move on your information before that information becomes public. Once the information in question is publicized, your legal options become limited.
  3. Be quiet: There are several reasons to keep silent about your claim. If you speak out against it, your employer might have time to cover up the wrongdoing in question. Additionally, it may prompt someone to beat you to that initial filing, thereby cutting you out of the process. So be careful about who you speak to and what you say.

A qui tam claim can serve two purposes. First, it can bring illegal activities to a screeching halt. Second, it can lead to significant financial recovery for you. In other words, there’s a lot at stake in these cases. Therefore, you shouldn’t leave anything to chance. Instead, think about discussing your situation with a trustworthy legal advocate who can help guide you through the process while protecting you from retaliation.