Wittels Law wants you to be fully informed of your rights and possible whistleblower claims that may be brought. If you have any questions that are not answered below, please contact us.
1. What is the False Claims Act?
The False Claims Act (the “FCA”) is a federal law (Title 31 U.S. Code Sections 3729 to 3733) that prohibits people from defrauding the federal government by knowingly presenting (or causing to be presented) a false or fraudulent claim to the government for payment.
2. Who is a typical whistleblower?
The FCA was designed to help U.S. taxpayers recover money stolen from the federal government. The FCA allows any person who is aware of a fraud or wrongdoing – such as fraudulent medical bills submitted to the government – to bring a lawsuit against the entity that committed the fraud.
Whistleblowers are typically current or former employees of the company engaged in the wrongdoing. The FCA has express language forbidding retaliation by employers against whistleblowers.
3. What are typical whistleblower cases brought under the False Claims Act?
Whistleblower cases involve a variety of government programs and/or contracts. Virtually any type of fraud in which the government has paid money, or has been billed for money, will likely fall under the FCA.
Here are some examples of frauds that whistleblowers have exposed:
Billing for services and goods that were never rendered or delivered;
Selling broken or untested equipment that fails to comply with contract specifications;
Billing for research that never occurred or was falsified;
Being overpaid by the government for a good or service and not reporting it;
Skimming profits off the sale of municipal bonds;
Lying about the value of imported goods, or about where the goods came from;
Lying about whether a contractor is a member of a minority group or a veteran; and
Mining or harvesting more natural resources from public lands than reported to the government.
Here are some examples that apply specifically to the field of health care:
Double billing for a service or good that only should have been billed once;
Billing for brand name drugs when generic drugs were used;
Hospice providers that accept unqualified patients or that improperly revoke a patient’s hospice admission to take advantage of Medicare;
Using multiple billing codes on medical tests in order to increase government reimbursement for the test (“unbundling”);
Lying by reporting – via billing codes – that a patient’s illness and costs were greater than they actually were (“upcoding”);
Lying about the true wholesale price of prescription drugs in order to receive a greater reimbursement;
Charging for work performed by a doctor that was actually performed by a nurse or resident intern; and
Nursing home practices that unfairly bill Medicare for certain services.
4. What if someone else has already filed a whistleblower suit against the company I’m thinking of suing?
If a previously-filed whistleblower suit is based on the same fraud you’re aware of, it is possible your suit could be dismissed. This aspect of the False Claims Act is sometimes called the “first to file” rule.
5. What are the benefits of being a whistleblower?
First, by serving as a whistleblower, you help protect American taxpayers against fraud.
If a whistleblower receives a favorable judgment or settlement in their case – thus allowing the government to recover money lost in the fraud – the person may receive 15 to 30 percent of that money that is recovered in the case. The government’s recovery could include up to three times the amount of money it paid out under the false claim, plus a penalty of $5,500 to $11,000 per false claim.
In order to be eligible to receive a portion of this payout, a person must have filed suit. Merely informing the government of the fraud is not enough.
6. What should I do if I know about fraud against the government?
Before you take any action, we recommend you contact us. If you decide to proceed with a case, Wittels Law can help you assemble as strong a case as possible.
The more prepared you are before filing suit, the higher your chance of success. It is also important not to discuss the fraud with anyone but your attorneys.
7. If I know about fraud, what is the deadline for filing a whistleblower suit?
Under the False Claims Act, a qui tam suit must be filed 1) within six years from the date of the fraud; or 2) three years after the government knew or should have known about the fraud, and no later than 10 years after the fraud. The better practice, however, is to file the case as soon as it is properly investigated.
8. What role does the government play in a whistleblower lawsuit?
Once a whistleblower suit has been filed, the government may decide to join your side in the suit. It is usually advantageous if the government decides to join your suit because your case will have the resources of the U.S. Department of Justice at its disposal. If the government declines to join you in your case, you can still proceed with it alone.
Working with experienced attorneys who have the capacity and experience to investigate and litigate complex cases from start to finish can increase the likelihood of the government joining your case, and is absolutely critical to the success of your case if the government declines intervention.
9. What if I have information on a state being defrauded, as opposed to the federal government?
Many states have their own version of the False Claims Act to discourage frauds against state and local governments. Those states are: California, Delaware, Washington D.C., Florida, Georgia, Hawaii, Illinois, Indiana, Louisiana, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oklahoma, Rhode Island, Tennessee, Texas, Virginia, and Wisconsin.
Some states have laws that mirror the federal FCA; others have laws limited to health care fraud; still others have unique provisions.
10. Can whistleblowers obtain a reward for reporting tax fraud?
Yes. The U.S. tax code has its own provisions that allow whistleblowers to obtain a reward for reporting tax fraud. As with the FCA, the IRS whistleblower provisions provide for whistleblowers to be awarded 15 to 30 percent of the amount recovered, plus triple damages.
11. Can whistleblowers obtain a reward for reporting securities fraud and other types of financial fraud?
Yes. The Dodd-Frank Wall Street Reform and Consumer Protection Act allows for any individual, or for two or more individuals acting jointly, to receive a reward if they provide the Securities and Exchange Commission, Commodity Futures Trading Commission, or other agencies information about violations of federal securities laws.
Examples of securities laws violations that would fall into this category are insider trading, accounting fraud, bribing a foreign official (Foreign Corrupt Practices Act violations), and money laundering. In order to receive a reward, the information turned over by the whistleblower must lead to the government recovering $1 million or more. If that requirement is met, the whistleblower can receive from 10 to 30 percent of the amount the government recovers.
These new Dodd-Frank whistleblower provisions also offer FCA-like protections against retaliation by employers.
Wittels Law can provide valuable assistance for individuals considering being a whistleblower on securities or tax fraud. Similar to FCA suits, seeking an attorney’s advice prior to filing such a suit is highly recommended.
12. What are the risks associated with being a whistleblower?
Whistleblower protections have dramatically expanded in recent years due to the passage of new laws and pro-employee interpretations of existing law. One example is the explicit anti-retaliation provision under the FCA.
The degree of legal protection a whistleblower receives depends on, among other issues, the type of whistleblowing, the role of the whistleblower, and the type of company.
13. How do I protect myself from retaliation for whistleblowing?
It is important that you seek legal advice early and meet with counsel. Please contact us to discuss your case. We will review your claim for free and with no obligation.
Important note about the information on this page:
This summary is for informational purposes only and does not constitute specific legal advice. Nor is this summary intended to create, and its receipt does not create, an attorney-client relationship. Please read our disclaimer.
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