Healthcare Whistleblower Attorney

Our Lawyers Help Whistleblowers Report Healthcare Billing Fraud to the Federal Government

Healthcare fraud costs American taxpayers tens of billions of dollars each year. While private insurance fraud is a concern, fraud within the federally funded healthcare system is a pervasive issue, and the federal government relies heavily on whistleblowers to help hold fraudulent actors accountable.

Our attorneys handle healthcare whistleblower cases nationwide. If you have information about any form of fraud anywhere in the healthcare industry, you may be eligible to come forward. In healthcare fraud cases, whistleblowers are entitled to stringent confidentiality protections, and they can become entitled to financial rewards in many cases as well.

Exposing Healthcare Fraud Under the False Claims Act

Typically, exposing healthcare fraud involves coming forward under the federal False Claims Act (FCA). We have extensive experience representing healthcare fraud whistleblowers in False Claims Act cases—including cases involving fraud under Medicaid, Medicare, and other federal healthcare programs. If you have questions about coming forward under the FCA, an experienced whistleblower attorney at our firm can explain everything you need to know.

Here is a brief introduction to what current employees, former employees, and other individuals need to know about reporting healthcare fraud to the federal government:

Types of Healthcare Fraud Covered Under the False Claims Act

Whistleblowers can report all forms of healthcare fraud under the False Claims Act. As experienced healthcare fraud attorneys, we are intimately familiar with the False Claims Act’s prohibitions in the healthcare sector and its protections for those who come forward. This includes (but is not limited to) those who come forward with information about:

Medicaid and Medicare Fraud

Medicaid and Medicare billing fraud are among the most common violations reported in healthcare whistleblower cases. If you have information about any form of Medicare or Medicaid fraud, you may be eligible to come forward as a protected whistleblower under the FCA. This includes (but is not limited to) all-too-common forms of fraud such as:

• Billing for medically unnecessary services
• Billing for services not actually provided to Medicare or Medicaid patients
• Double-billing Medicare or Medicaid and private insurers
• Falsifying patient records to claim medical necessity
• Upcoding, unbundling, and other fraudulent billing practices

We help Medicare and Medicaid whistleblowers expose all other forms of fraud related to designated health services as well. Fraudulent claims under these programs are extraordinarily common, and exposing fraud (or even suspected fraud) is critical for holding healthcare providers accountable and preventing additional fraud in the future.

Tricare and DOL Fraud

Along with cases involving Medicare and Medicaid fraud, we also represent whistleblowers in cases involving fraud under other government health care programs. This includes Tricare and the U.S. Department of Labor (DOL) health care program, among others. Here too, individuals who are prepared to expose violations can come forward under the False Claims Act; and, if they help the U.S. Department of Justice (DOJ) recover taxpayer dollars, they are entitled to a percentage of the funds recovered.

Anti-Kickback Statute and Stark Law Violations

The Anti-Kickback Statute and Stark Law are federal laws that prohibit healthcare providers from soliciting or paying for referrals of Medicare and Medicaid patients. Offering, paying, soliciting, and accepting illegal kickbacks or referral fees are all violations that whistleblowers can expose in qui tam cases under the False Claims Act. If you have information about a healthcare provider (or any other entity) accepting payments for referring patients or seeking payments for patient referrals, we encourage you to speak with a healthcare whistleblower attorney at our firm about coming forward.

Prescription Drug Fraud

Healthcare whistleblowers can also file qui tam lawsuits under the False Claims Act in cases involving prescription drug fraud and other forms of pharmaceutical fraud. This includes everything from improper financial relationships to fraudulent schemes involving federal healthcare program beneficiaries. While several government agencies investigate allegations of prescription drug fraud, working with an experienced attorney to file a complaint under the False Claims Act is the first step in the process.

Durable Medical Equipment (DME) Fraud

Healthcare whistleblowers can also expose all forms of durable medical equipment (DME) fraud under the False Claims Act. This includes everything from offering illegal financial incentives and accepting illegal referral fees to improperly billing for the use of DME in connection with designated healthcare services. Here too, such fraud can be costly for both patients and taxpayers, and whistleblowers play an important role in helping the government hold bad actors accountable.

Filing a Qui TamWhistleblower Lawsuit Under the False Claims Act

Coming forward under the False Claims Act is a unique legal process that involves filing a qui tam lawsuit in federal court. This is a lawsuit filed on behalf of the federal government to recover payments secured through fraudulent means.

Once a healthcare whistleblower files a qui tam complaint under the False Claims Act, the government investigates the whistleblower’s allegations to determine whether further action is warranted. After investigating, the government will decide whether to intervene. As discussed below, the government’s decision regarding intervention impacts the amount of a whistleblower’s award; however, even if the government declines to intervene, whistleblowers can still seek accountability with the help of qualified legal counsel.

Securing a Whistleblower Reward if Your Case is Successful

The False Claims Act includes provisions for monetary awards in successful cases. Broadly, whistleblower awards in healthcare fraud cases range from 15% to 30% of the amount recovered. If the government intervenes, the award range is 15% to 25%. If the government declines to intervene, a whistleblower is entitled to receive 25% to 30% of any funds recovered on the government’s behalf.

Why to Choose the Healthcare Whistleblower Attorneys at Oberheiden P.C.

Let’s say you are thinking about coming forward as a healthcare whistleblower. Why should you choose the healthcare whistleblower attorneys at Oberheiden P.C.?

• We are a whistleblower law firm that is dedicated to helping individuals expose all forms of fraud, waste, and abuse.
• We handle whistleblower cases involving fraud perpetrated by doctor’s offices, clinics, hospitals, pharmaceutical companies, DME companies, and all other entities in the healthcare industry.
• We are committed to protecting our clients’ identities, and we rely on our experience to work directly with the federal government on behalf of our clients.
• We have successfully represented clients in False Claims Act cases involving an extremely wide range of allegations.
• We help maximize our clients’ reward eligibility, and we work to secure our clients’ monetary awards on their behalf when warranted.

FAQs: How to Report Fraud as a Healthcare Whistleblower

Schedule a Free Consultation to Speak with an Experienced Federal Healthcare Whistleblower Lawyer in Strict Confidence

Are you interested in coming forward as a healthcare whistleblower? If so, we strongly encourage you to contact us for a free consultation today. We work with potential healthcare fraud whistleblowers nationwide. To speak with an experienced federal healthcare whistleblower lawyer in strict confidence as soon as possible, call 866-320-3959 ortell us how we can reach you online now.

Further Information

• Healthcare Whistleblower Reward Attorney
• Healthcare Whistleblower Protection Act