Paul Tassin  |  May 26, 2016

Category: Labor & Employment

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Whistleblower RewardFraud committed against the Medicaid system costs billions in taxpayer dollars every year. Tracking it down and punishing it is an additional expense on its own.

Fortunately, those who file a whistleblower lawsuit with good evidence of Medicaid fraud may be entitled to collect a whistleblower reward in proportion to the amount of money recovered.

The evidence of Medicaid fraud frequently shows up in the paperwork generated by providing care that’s billed to Medicaid. Certain tactics of fraudsters show up again and again in whistleblower lawsuits.

One common and simple tactic is the prescription of treatments, particularly medications, that aren’t medically necessary.

A related tactic is one known as “upcoding”: diagnosing a patient with a more severe condition than the one they actually have, in an attempt to justify more expensive treatment.

Some providers have also been caught billing Medicaid at higher rates than those at which they bill other payers.

Protections for Whistleblowers

Often the persons with the most useful evidence of Medicaid fraud are employees of the businesses that are doing the defrauding. Physicians, their staff, pharmacists, laboratory technicians or anyone else with inside access to the provision of health care may come across evidence of Medicaid fraud at some point.

Since these employees could be at risk for retaliation from their employers if they blow the whistle on Medicaid fraud, federal whistleblower law protects those employees from retaliation by employers.

Victims of retaliation may get reinstatement, double their back pay and reimbursement of their litigation costs and attorneys’ fees. Other protections may also be available under state whistleblower law.

Reaping the Whistleblower Reward

In enacting the False Claims Act, Congress tried to make whistleblower rewards large enough to be worthwhile. A successful whistleblower may be entitled to anywhere from 15 to 30 percent of the amount of money recovered in a successful whistleblower lawsuit.

Most successful actions yield whistleblower rewards on the lower end of that range, between 15 and 25 percent. These are cases in which the government intervenes in the lawsuit and takes the whistleblower’s place as the lead plaintiff in the action.

In every whistleblower lawsuit filed, the government gets the opportunity to investigate the allegations and intervene if it believes the claims have merit.

If the government decides not to intervene, the whistleblower has the option of continuing to prosecute the claim. A successful plaintiff in that situation can expect a larger share of the recovery – between 25 and 30 percent.

Civil penalties under the False Claims Act are no joke, and the more money the government collects from the perpetrator, the larger the whistleblower reward.

If the lawsuit is successful, the person or business who defrauded the government may be on the hook for three times the dollar amount of the fraud, plus penalties of $5,000 to $10,000 for each false claim made against the government.

It’s important to remember that the only way to get whistleblower rewards is to file a whistleblower lawsuit. Merely tipping off investigators doesn’t entitle the informant to a reward, even if it eventually results in a successful prosecution for fraud.

In general, whistleblower and qui tam lawsuits are filed individually by each plaintiff and are not class actions. Whistleblowers can only join this investigation if they are reporting fraud against the government, meaning that the government must be the victim, and that the alleged fraud should be a substantial loss of money.

Do YOU have a legal claim? Fill out the form on this page now for a free, immediate, and confidential case evaluation. The attorneys who work with Top Class Actions will contact you if you qualify to let you know if an individual qui tam lawsuit or whistleblower class action lawsuit is best for you. Hurry — statutes of limitations may apply.

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Join a Free Whistleblower, Qui Tam Lawsuit Investigation

If you believe that you have witnessed fraud committed against the government, you may have a legal claim. Whistleblowers can only join this investigation if they are reporting fraud against the government, meaning that the government must be the victim, and that the alleged fraud should be a substantial loss of money.

See if you qualify to pursue compensation and join a whistleblower lawsuit investigation by submitting your information for a free case evaluation.

An attorney will contact you if you qualify to discuss the details of your potential case.

Please Note: If you want to participate in this investigation, it is imperative that you reply to the law firm if they call or email you. Failing to do so may result in you not getting signed up as a client, if you qualify, or getting you dropped as a client.

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Please note: Top Class Actions is not a settlement administrator or law firm. Top Class Actions is a legal news source that reports on class action lawsuits, class action settlements, drug injury lawsuits and product liability lawsuits. Top Class Actions does not process claims and we cannot advise you on the status of any class action settlement claim. You must contact the settlement administrator or your attorney for any updates regarding your claim status, claim form or questions about when payments are expected to be mailed out.