Healthcare Rebate Program Kickback Whistleblowers
We Help Healthcare Fraud Whistleblowers Report Illegal Kickbacks Under the Federal False Claims Act
Several federal whistleblower laws include provisions for financial rewards. Under these laws, when eligible whistleblowers expose fraud or other illegal activity and help the government pursue successful enforcement actions, they are entitled to a percentage of the funds the government recovers.
When it comes to exposing statutory violations and other forms of wrongdoing, whistleblowers have several options. While the federal False Claims Act is among the most well-known whistleblower reward statutes, there are several others as well. Our whistleblower lawyers help individuals come forward under all of these statutes, and we work with the federal government to secure whistleblower rewards on behalf of our clients as warranted.
Options for Seeking a Whistleblower Reward from the Federal Government
Within the federally funded healthcare industry, healthcare providers and other entities are subject to a variety of prohibitions that are intended to ensure taxpayer funds are used to pay for necessary medical care. These include prohibitions on rebates paid out of Medicare, Medicaid, and other government healthcare programs. However, these rebates remain common, and the federal government relies heavily on whistleblowers to expose when civil or criminal enforcement action is warranted.
Illegal rebates are among the many issues that are to blame for rising healthcare costs for patients and families. As a result, the federal government has prioritized targeting these illegal payments and other similar types of illegal financial relationships in recent years. If you have information that you believe may be of interest to the federal government, you may be eligible to serve as a healthcare rebate program kickback whistleblower—and you may be eligible to receive a monetary reward for your efforts.
The Anti-Kickback Statute Applies to Rebates and Other Forms of “Remuneration” Under Federal Health Care Programs
Illegal rebates fall under the prohibitions of the federal Anti-Kickback Statute (AKS). The Anti-Kickback Statute prohibits health care providers, pharmaceutical companies, medical device companies, and other entities from paying illegal kickbacks under the Medicare and Medicaid programs. The term “kickback” is defined broadly—and includes not only referral fees and other direct payments, but also rebates and other kickback schemes that result in the improper use of taxpayer dollars.
Paying and receiving kickbacks are both prohibited under the Anti-Kickback Statute. The AKS also prohibits offering or soliciting illegal kickbacks, even if these efforts are unsuccessful. From cases involving biotechnology companies to cases involving orthopedic surgeons, we help whistleblowers expose all types of illegal rebates (and efforts to offer or solicit rebates) to the federal government.
Healthcare Rebates May Also Violate the Stark Law and Civil Monetary Penalties Law
In some cases, illegal healthcare rebates may also violate the Physician Self-Referral Law (Stark Law) and the Civil Monetary Penalties Law. Pharmaceutical kickbacks involving prescription drugs, durable medical equipment (DME) kickbacks involving implants and equipment, and numerous other forms of rebates within the health care industry can potentially violate these federal statutes. We help whistleblowers throughout the federally funded healthcare system expose violations of these statutes as well.
Whistleblowers Can Report Illegal Rebates Involving Medical Services, Durable Medical Equipment, and Other Items Under the False Claims Act
In almost all cases, exposing illegal rebates involving funds received under federal healthcare programs involves filing a False Claims Act lawsuit in federal court. The False Claims Act applies in cases involving Medicare fraud, Medicaid fraud, and fraud under all other government health care programs. Medical providers and other entities and individuals can face liability under the False Claims Act for engaging in unlawful practices including (but not limited to):
- Offering doctors kickbacks (rebates) if they agree to use a company’s devices or drugs
- Offering to pay kickbacks in an effort to induce referrals for Medicare patients or Medicaid patients
- Perpetrating (or attempting to perpetrate) any other illegal kickback scheme involving efforts to receive “remuneration” in exchange for a promise to refer patients or to pay below fair market value for items or services
In qui tam cases under the False Claims Act, whistleblowers can report not only violations of the Anti-Kickback Statute, but also violations of the Stark Law and Civil Monetary Penalties Law. Ultimately, if you have information about any fraudulent practices related to healthcare rebates (or other healthcare kickbacks) and have questions about coming forward, we encourage you to contact us for a free and confidential consultation.
Filing a Whistleblower Claim (Qui TamLawsuit) Under the False Claims Act
Filing a whistleblower claim (qui tam lawsuit) under the False Claims Act is a unique process. Our lawyers have extensive experience helping whistleblowers navigate the process in cases involving Anti-Kickback Statute violations, Stark Law violations, and other violations of federal law. Here is what you can expect when you contact us about coming forward:
1. We Will Explain the Process of Serving as a False Claims Act Whistleblower
Our attorneys will explain everything you need to know about serving as a whistleblower under the False Claims Act. We will walk you through the process of coming forward, helping the federal government pursue civil liability or criminal penalties, and securing your whistleblower reward if your case is successful.
2. We Will Assess Your Eligibility to Blow the Whistle
Before you make any decisions, we will assess your eligibility to blow the whistle. We will assess whether the information you have in your possession reflects a healthcare rebate that is prohibited under the Anti-Kickback Statute or Stark Law. If it does, we will then take the other steps that are necessary to confirm whether you qualify to come forward. Based on this assessment, you will be able to make informed and confident decisions about your next steps.
3. We Will Handle Your Healthcare Rebate Whistleblower Case at No Out-of-Pocket Cost
If you decide to blow the whistle, we will handle your healthcare rebate whistleblower case at no out-of-pocket cost to you. Our legal fees, if any, will be deducted from any monetary reward we help you secure. In successful False Claims Act cases, whistleblowers are generally entitled to between 15% and 30% of the government’s recovery.
Prescribing physicians, pharmaceutical manufacturers, hospitals, clinics, and other healthcare entities can all be held liable for offering, paying, soliciting, and accepting unlawful rebates in appropriate cases. The federal prohibitions against these rebates are intended to protect patients and taxpayers, and the federal government takes whistleblowers’ allegations seriously. If you are unsure whether rebates constitute legitimate payments or illegal kickbacks, our attorneys can examine the transactions in question and then advise you based on our assessment of their legality.
FAQs: Reporting Illegal Healthcare Rebates to the Federal Government
Does the federal anti-kickback law prohibit healthcare providers from receiving rebates under Medicare and Medicaid?
The federal Anti-Kickback Statute (AKS) prohibits healthcare providers from receiving many types of rebates under Medicare and Medicaid. While the AKS provides safe harbors for certain types of legitimate transactions, any rebates are subject to scrutiny, and healthcare providers and other entities must be extremely careful to structure these discounts in such a way that they do not violate federal law.
Are whistleblowers entitled to a portion of any Anti-Kickback Statute penalties recovered?
Under the False Claims Act, whistleblowers who help the federal government secure recoupments, fines, and/or other penalties under the False Claims Act are entitled to between 15% and 30% of the government’s recovery. The specific percentage of a whistleblower reward under the False Claims Act depends on several factors—most notably: (i) the value of the information provided; (ii) the whistleblower’s additional assistance during the government’s investigation; and, (iii) whether the government intervenes in the case. When we represent whistleblowers in False Claims Act cases, we work with the government on their behalf to help maximize their reward eligibility.
If I report my employer for paying or receiving an illegal rebate, will I be protected against retaliation?
The False Claims Act prohibits employer retaliation against whistleblowers. If you qualify as a whistleblower under the False Claims Act, your employer will be prohibited from retaliating against you based on your decision to blow the whistle. Importantly, False Claims Act whistleblowers are also entitled to strict confidentiality, and whistleblowers’ identities will remain unknown in most cases.
Should I report illegal healthcare rebates to state or federal authorities?
While healthcare personnel can report illegal rebates under state false claims acts in some cases, most whistleblowers will want to come forward under the federal False Claims Act. Not only does the federal False Claims Act provide strong confidentiality and anti-retaliation protections, but it also includes provisions for whistleblower rewards in appropriate cases. In some cases, healthcare providers, pharmaceutical manufacturers, and other entities will pay millions to settle False Claims Act allegations. As a result, whistleblower rewards have the potential to be substantial—though each case is unique.
How do I report illegal healthcare rebates to the federal government?
As discussed above, reporting illegal healthcare rebates to the federal government generally involves coming forward under the False Claims Act. We help healthcare whistleblowers come forward under the False Claims act at no out-of-pocket cost. If you think you may be in a position to report illegal rebates to the federal government and have questions about coming forward, we strongly encourage you to schedule a free and confidential consultation with one of our senior attorneys.
Experienced Legal Counsel for Healthcare Rebate Cases Under the False Claims Act – Schedule a Free and Confidential Consultation Today
To speak with one of our senior attorneys about exposing illegal rebates (or other illegal kickbacks) to the federal government, contact us today. Call us at 866-320-3959 or tell us how we can reach you online and we will schedule your free and confidential consultation as soon as possible.