HHS Whistleblower Attorney

We Help Healthcare Whistleblowers and Federal Employees Report Fraud Involving All HHS Programs

The U.S. Department of Health and Human Services (HHS) is responsible for overseeing Medicare and Medicaid—the two largest government healthcare programs in the United States. While other government agencies assist with enforcing compliance, HHS holds primary responsibility for ensuring that Medicare and Medicaid funds are not lost to fraud, waste, and abuse.

Due to the volume of fraud under Medicare and Medicaid, HHS relies heavily on whistleblowers to come forward. Our whistleblower lawyers assist individuals in the public and private sectors with coming forward, and we handle HHS whistleblower cases across the country.

Reporting Healthcare Fraud Under the False Claims Act

We help whistleblowers report fraud, waste, abuse, and all other forms of unethical conduct impacting the federally funded healthcare system. If you have questions about reporting alleged wrongdoing to HHS, we strongly encourage you to contact us for a free and confidential consultation. For healthcare providers and other individuals in the private sector, coming forward will often involve filing a qui tam lawsuit under the False Claims Act instead—and, in all cases, a cautious and informed approach is required.

Information for Individuals in the Healthcare Industry

Individuals in the healthcare industry who have information about Medicare or Medicaid fraud may be eligible to come forward under the federal False Claims Act (FCA). The FCA is a whistleblower statute that provides both protections and financial incentives for coming forward.

Under the FCA, current and former employees can report fraudulent claims under Medicare and Medicaid, as well as various other forms of fraud impacting HHS. We have extensive experience helping individuals file lawsuits under the FCA, and our experienced whistleblower attorneys can take appropriate legal action on your behalf if warranted. Some examples of violations that may warrant filing a whistleblower claim under the FCA include:

• Incorrectly billing Medicare or Medicaid
• Billing Medicare or Medicaid for services not rendered (“phantom billing”)
• Falsifying billing or patient records
• Anti-Kickback Statute violations
• Stark Law violations

If you have a reasonable belief that your employer, your former employer, or any other entity has violated federal law, an HHS whistleblower attorney at our firm can help you make an informed decision about making a protected disclosure. We represent all of our whistleblower clients at no out-of-pocket cost. Our attorney’s fees, if any, are calculated as a percentage of the funds we help our clients recover.

Information for HHS Contractors

Current and former employees of federal contractors working with HHS may also be eligible to file whistleblower lawsuits under the False Claims Act. We handle False Claims Act litigation on behalf of current and former employees of HHS contractors as well. If you have questions about filing a whistleblower complaint against your current or former employer, we can explain everything you need to know—including important information about the whistleblower protections and compensation that are available.

Examples of violations that current and former employees of HHS contractors may be able to report under the FCA include:

• Bidding and procurement fraud
• Bribery and corruption
• Inaccurate billing under HHS contracts
• Material and service substitution
• Other forms of fraud under HHS contracts

These violations, among others, can expose HHS contractors to substantial penalties—including criminal penalties in some cases. Our HHS whistleblower attorneys are available to help current and former employees report all types of violations under the False Claims Act. If you have questions about coming forward, our attorneys can help you make informed and confident decisions about your next steps.

Information for HHS Employees

Current and former HHS employees can also serve as whistleblowers in various circumstances. While federal personnel generally are not eligible to file complaints under the False Claims Act, they may be able to come forward under HHS’s whistleblower program or through other means.

HHS personnel can report a wide range of violations both involving Medicare and Medicaid fraud and involving wrongdoing within HHS itself. For example, whistleblowers play an important role in helping the HHS Office of Inspector General (HHS OIG) take action against violations including:

• Abuses of authority
• Gross mismanagement of taxpayer money
• All other forms of fraud, waste, and abuse
• Fraud involving scientific research
• Other substantial and specific dangers to public health and safety

If you are interested in coming forward as a current or former HHS employee, our attorneys can determine the appropriate whistleblower statute under which you should come forward. While this will be the Whistleblower Protection Act (WPA) in many cases, there are other possibilities as well.

More Information on False Claims Act Cases Involving HHS Program Fraud

As discussed above, healthcare workers, employees of HHS contractors, and other individuals in the private sector will often need to file qui tam lawsuits under the False Claims Act in order to come forward as whistleblowers. While it is not possible for potential whistleblowers to remain anonymous when coming forward under the False Claims Act, FCA whistleblowers are entitled to strict confidentiality and protection against retaliatory adverse employment actions.

FCA whistleblowers are also entitled to a monetary reward if they help the government pursue a successful enforcement action. Under the FCA, whistleblower rewards are calculated as a percentage of the government’s recovery. This typically ranges from 15% to 30% of the taxpayer money and monetary sanctions recovered—which means that whistleblower rewards have the potential to be substantial. Factors that can impact the percentage of an FCA whistleblower reward include:

• The amount of information provided in the whistleblower’s complaint
• The value of the information provided in the whistleblower’s complaint
• The amount of additional assistance provided during the government’s investigation
• Whether the whistleblower played any role in the fraud reported
• Whether the healthcare provider or contractor in question was already on HHS’s or the U.S. Department of Justice’s (DOJ) radar

When a whistleblower files a valid qui tam lawsuit under the False Claims Act, the DOJ is obligated to conduct an investigation. After conducting its investigation, the DOJ will decide whether to “intervene.” If the DOJ intervenes, it will take over the case, and the whistleblower will generally be entitled to an award of 15% to 25% of the amount recovered if the case is successful. If the DOJ declines to intervene, the whistleblower can continue pursuing False Claims Act litigation independently, and the whistleblower will be entitled to an award of 25% to 30% of the amount recovered in this scenario.

FAQs: Exposing Fraud Under Federal Healthcare Programs

Contact Oberheiden P.C. | A National Healthcare Whistleblower Law Firm

If you would like to speak with an HHS whistleblower attorney about possibly coming forward, we invite you to get in touch. Call us at 866-320-3959 or contact us online to schedule a free and confidential consultation today.