A lawyer colleague from Connecticut sent me a recent editorial from the Record Journal news. The editorial spoke to the growing Medicare fraud problem nationally and in Connecticut. While everything in the editorial is technically accurate, the paper failed to highlight the important role that whistleblowers play in fighting this epidemic.
The FBI says that Medicare fraud is indeed an epidemic and costs taxpayers up to $80 billion per year. While some folks struggle to find affordable care, a few greedy doctors, clinics and healthcare professionals are robbing us blind.
According to their editorial, “there seem to be plenty of fraudsters out there… and the government is trying to fight them with a limited number of attorneys and prosecutors. Uncle Sam may be woefully outnumbered.”
No, the government is not outnumbered, not when you count the government’s primary ally and partner in the fight against Medicare fraud – whistleblowers. The federal False Claims Act empowers ordinary healthcare workers to file lawsuits in the name of the U.S. government and keep a portion of whatever is recovered from wrongdoers. Those whistleblowers have been extremely effective in ferreting out healthcare fraud.
Many states, including Connecticut, have their own False Claims Act laws that can pay whistleblower awards in Medicaid fraud cases.
Last year the federal government paid out $635 million in awards to whistleblowers, much of that in Medicare fraud cases. (Our clients received over $100 million.) The Justice Department says that whistleblowers helped save the government $5 billion last year.
We agree that alone, Uncle Sam isn’t very effective at fighting Medicare fraud. Add whistleblowers to the mix, however, and fraud can be stopped.
To qualify for a whistleblower award, one must have original source (inside) knowledge of Medicaid or Medicare fraud. Receiving an award also usually means being first to file so waiting too long may mean that someone else files first.
Medicare fraud claims under the federal False Claims Acts are filed under seal in a federal court. The case remains secret while investigated by the government. During and after the case, whistleblowers are generally entitled to protection under both state and federal and anti-retaliation laws.
Assuming the government recovers money, the last step is determining how much the whistleblower will get to keep. Normally that percentage is between 15% and 30%.
Want to learn more or think you have information about Medicare fraud? Give us a call. Whistleblower cases are handled on a contingent fee basis and all inquiries are protected by the attorney – client privilege and kept strictly confidential.
MahanyLaw – America’s Whistleblower & Medicare Fraud Lawyers