Whistleblower Claims
At Stueve Siegel Hanson, we stand with individuals who have the courage to come forward and expose fraud, misconduct, and violations of the law. Our employment and compensation attorneys help whistleblowers navigate the complex legal landscape and ensure they receive the protection and compensation they deserve.
Whistleblowers play a critical role in safeguarding public funds, especially in the healthcare sector, where fraudulent activities can have far-reaching consequences for patients, taxpayers, and the entire healthcare system. We are here to guide you through every step of the whistleblower process and help you make a meaningful difference.
Understanding Whistleblower Claims
Whistleblower claims involve reporting illegal or unethical activities, typically in the workplace, to the authorities. These claims are filed under various federal and state laws designed to encourage individuals to come forward and report misconduct, with the promise of protection from retaliation and, in some cases, financial rewards.
In the healthcare sector, the False Claims Act and similar state statutes apply to many empower people with material, non-public information to come forward and identify waste, fraud, and abuse with respect to federal and state money. In the healthcare space, this frequently concerns billings by hospitals to Medicare, Medicaid, or other government healthcare programs.
The False Claims Act
The False Claims Act (FCA) is a federal law that imposes liability on individuals or entities that defraud government programs. Enacted during the Civil War to combat fraud in government contracts, the FCA has evolved into a powerful tool for whistleblowers to expose fraud, particularly in the healthcare industry.
Under the FCA, individuals referred to as “relators” can file lawsuits on behalf of the government, alleging that a person or organization has submitted false or fraudulent claims for payment to the government. Common examples in the healthcare setting include billing for services not rendered, inflating the costs of services, or providing unnecessary medical procedures to increase profits.
Whistleblowers who bring successful claims under the FCA are entitled to a portion of the government’s recovery, typically ranging from 15 to 30 percent of the total amount recovered. In addition to financial rewards, the FCA also provides protections against retaliation, ensuring that whistleblowers cannot be legally punished or face adverse employment actions as a result of their decision to come forward.
Common Healthcare Fraud Violations
Fraudulent practices can take many forms, and those who work in healthcare are often in the best position to identify and report these illegal activities. Common forms of healthcare fraud include:
- Billing for services not provided: This occurs when healthcare providers bill for procedures or services that were never performed. It is one of the most frequent forms of Medicare and Medicaid fraud.
- Upcoding: Upcoding happens when providers bill for more expensive services than were actually provided, thereby inflating the costs.
- Unnecessary medical procedures: Some healthcare providers may perform unnecessary tests, surgeries, or treatments solely to increase their revenue from government healthcare programs.
- Kickbacks and illegal referrals: The Anti-Kickback Statute (ASK) prohibits healthcare providers from offering, paying, soliciting, or receiving anything of value to induce or reward referrals for services covered by government healthcare programs. Violations of this law can also give rise to FCA claims.
- Pharmaceutical fraud: This can include illegally marketing drugs for unapproved uses, overcharging the government for prescription medications, or offering kickbacks to doctors who prescribe certain medications.
Our firm identifies, investigates, and litigates these types of healthcare fraud claims. We understand the complexity of healthcare billing practices and are well-equipped to handle even the most intricate cases. Our ability to handle complex and sensitive matters is evident in both our track record and our awards and recognitions.
Whistleblower Protections Under the False Claims Act
One of the greatest concerns potential whistleblowers have is fear of retaliation. It is natural to worry about losing your job, damaging your career, or facing workplace harassment as a result of reporting wrongdoing. Fortunately, the FCA includes robust protections for whistleblowers.
Retaliation Protections
The FCA prohibits any form of retaliation against employees who report fraud. This includes being fired, demoted, harassed, or otherwise discriminated against because of your whistleblowing activities. If you face retaliation, you have the right to file a separate lawsuit seeking damages, which can include:
- Reinstatement to your previous position
- Twice the amount of back pay you are owed
- Compensation for any legal costs or attorney’s fees
Our firm is committed to pursuing your whistleblower claim and ensuring that you are fully protected from any form of retaliation.
IRS and SEC Whistleblower Programs
While our primary focus is on healthcare fraud and the False Claims Act, our firm also investigates claims under the IRS Whistleblower Program and the SEC Whistleblower Program. These programs offer similar protections and financial incentives to whistleblowers who report violations in different sectors.
IRS Whistleblower Program
The IRS Whistleblower Program rewards individuals who report tax fraud and evasion. Under this program, whistleblowers can receive between 15 and 30 percent of the amount recovered by the IRS, provided that the taxes owed exceed $2 million. Examples of tax fraud include underreporting income, falsifying deductions, and failing to pay employment taxes.
If you have information about a company or individual engaging in significant tax fraud, we can help you navigate the IRS Whistleblower Program and protect your rights.
SEC Whistleblower Program
The SEC Whistleblower Program offers rewards to individuals who report securities law violations, such as insider trading, market manipulation, or fraudulent financial reporting. Similar to the FCA and IRS programs, whistleblowers under the SEC program are eligible for rewards ranging from 10 to 30 percent of the monetary sanctions collected by the SEC if the amount exceeds $1 million.
If you work in the financial industry or have information about securities fraud, we can help you file a claim with the SEC and seek the rewards and protections available to you.
How to Report a Whistleblower Claim
If you believe you have information about fraud or abuse in the healthcare industry, you can report it to the Department of Justice (DOJ), Department of Health and Human Services (DHHS), or Centers for Medicare & Medicaid Services (CMS). Reporting a whistleblower claim involves several critical steps:
- Document the evidence: Gather detailed information about the fraud or illegal activities you are exposing.
- Consult an attorney: Speak with our lawyers, who are experienced in whistleblower claims, to understand your legal options and ensure your legal protections.
- File the claim: Depending on the type of claim, we will help you file under the appropriate law, such as the False Claims Act, IRS Whistleblower Program, or SEC Whistleblower Program.
- Protect your identity: If you are concerned about retaliation, you may want to remain anonymous during the initial stages of the investigation. For example, under the False Claims Act, the case will be sealed and confidential until the government decides whether to intervene.
- Cooperate with the government: Government agencies will often investigate your case, and cooperation is crucial.
- Remain protected: Federal laws protect whistleblowers from retaliation. Make sure you understand your rights.
Remember, reporting a whistleblower claim is a courageous and righteous act. Exposing wrongdoing can help protect the public and hold those responsible accountable.
Why Work with Stueve Siegel Hanson?
When you choose our firm to represent you in a whistleblower claim, you are partnering with a team of experienced attorneys who have a proven success record in complex, high-stakes. Stueve Siegel Hanson has been recognized nationally for securing multimillion-dollar verdicts and settlements, making us a top choice for whistleblower cases, especially those involving healthcare fraud.
Contact Us Today
Do not wait if you are considering filing a whistleblower claim. The sooner you act, the better your chances of success. Contact our office today to schedule a confidential consultation with one of our experienced whistleblower attorneys. For an extra measure of discretion, you may contact Alex Ricke directly at 816.714.7141.
Let us help you take the first step toward justice, protection, and financial rewards.
Do you have additional questions about the whistleblower process? Review our Frequently Asked Questions for whistleblower claims.