The law protects those who seek to tell the truth and uncover fraudulent practices or behaviors in businesses. When these alleged acts of fraud are against the federal government, individuals who “blow the whistle” are protected under the False Claims Act.

Recently a man who participated in fraudulent acts against the government was sentenced to eight years in jail for his alleged role in a $10 million health care fraud scheme.

In Miami, Vladamir P., age fifty-two, was sentenced to 97 months in prison and ordered to pay over $4 million in restitution for health care fraud.

According to the U.S. Department of Justice, Vladamir pled guilty to “one count of conspiracy to commit health care fraud and wire fraud charged in an October 2017 superseding indictment and to one count of conspiracy to commit health care fraud and wire fraud charged in a November 2017 indictment.”

He admitted that he owned a medical clinic in Miami that submitted $5 million in false and fraudulent claims to Blue Cross Blue Shield. This health care fraud allegedly resulted in $2.6 million in payments to the clinic.

He also admitted that he was part owner in a Miami rehabilitation clinic that submitted an additional $2.6 million in false claims also to Blue Cross Blue Shield. These health care fraud claims resulted in $1.4 million in payments to the clinic.

In another instance of health care fraud, Vladamir also allegedly purchased a fraudulent home health care agency. Through this false home health care agency, Vladamir and his co-conspirators “submitted to the Medicare program, via interstate wires, approximately $2.2 million in claims for reimbursement, which falsely and fraudulently represented that various home health care benefits were medically necessary, prescribed by a doctor and provided to Medicare beneficiaries.”

The Department of Justice reports that $3.9 million in payments were received by Vladamir because of false claims that his home health agency made.

The Medicare Fraud Strike Force was the primary investigative entity in this health care fraud narrative.

Blowing the Whistle on Health Care Fraud

If a person has evidence or knowledge that health care fraud is being committed by the federal government via Medicare or Medicaid claims, for example, that individual is protected by federal law. The employer may not, under the False Claims Act, retaliate in any way against that individual.

In fact, the individual who blows the whistle may not only keep the company accountable for wrongdoing, but the person may reap a monetary reward. A company who commits health care fraud of this nature may be subject to steep fines.

The whistleblower can receive back pay if they have been fired (up to twice the amount owed) and may even receive a portion of the settlement for blowing the whistle on fraud. This person can receive 15 to 25 percent of the amount recovered, compensation for expenses and legal fees.

If you believe you may be able to blow the whistle on health care fraud, you may be wise to speak with an experienced attorney. A whistleblower attorney may be able to help you navigate the legal process when it comes to filing a health care fraud lawsuit on behalf of the government.