Medicare Whistleblower Reward Attorney

Learn About the Rewards Available to Whistleblowers Who Expose Medicare Fraud Under the False Claims Act

Medicare fraud is a pervasive issue across all segments of the healthcare industry. All types of healthcare providers commit Medicare fraud—and, far too often, they get away with it. As a result, Medicare fraud costs U.S. taxpayers tens of billions of dollars annually, and the federal government relies heavily on whistleblowers to expose providers’ violations of federal law.

Our experienced healthcare fraud attorneys help whistleblowers expose Medicare fraud under the federal False Claims Act (FCA). Under the FCA, eligible whistleblowers who assist the federal government with pursuing successful enforcement actions involving federal health insurance programs are entitled to a percentage of the taxpayer funds recovered.

Medicare Fraud Whistleblowers May Be Entitled to Substantial Rewards Under the False Claims Act

Whistleblower rewards under the False Claims Act have the potential to be substantial. In healthcare fraud cases, whistleblowers are generally entitled to between 15% and 30% of the government’s recovery. Since cases involving fraud under the Medicare program can involve hundreds of thousands, millions, or even tens of millions of dollars in fraudulent billings, whistleblowers will often have a strong financial incentive to come forward.

Reporting Medicare Fraud to the Federal Government

Seeking a whistleblower reward under the FCA involves filing a qui tam lawsuit. This is a lawsuit filed on behalf of the federal government to recover healthcare costs that were paid in error. Both intentional and unintentional fraudulent billings under the Medicare and Medicaid programs can warrant qui tam lawsuits, and we have significant experience representing Medicare and Medicaid whistleblowers in these cases.

When can you report healthcare fraud under the FCA and seek a monetary reward? Some of the most common allegations in qui tam cases involving fraud under Medicare, Medicaid, and other government healthcare programs include:

• Billing for medically unnecessary services provided to Medicare and Medicaid patients
• Improperly billing for designated health services (i.e., upcoding or unbundling)
• Offering or accepting illegal kickbacks for referring patients covered under Medicare or Medicaid
• Accepting other forms of illegal remuneration from pharmaceutical companies or healthcare professionals
• Double-billing the federal government and private insurers (which also constitutes private insurance fraud)

These are just examples. If you believe that you have any information about billing fraud in any segment of the federally funded healthcare system, we strongly encourage you to speak with a healthcare fraud whistleblower attorney at our law firm about the possibility of coming forward.

How the Federal Government Calculates Medicare Whistleblower Rewards in False Claims Act Cases

In Medicare fraud cases, whistleblower rewards are calculated based on several factors. When we represent whistleblowers in these cases, we work with the government on behalf of our clients to help maximize their reward eligibility. Some of the key factors that can influence reward calculations in these cases include:

• The Scope and Severity of the Fraud – Medicare and Medicaid fraud cases can involve violations of both federal and state laws. While qui tam cases only involve violations of federal laws, the scope and severity of the fraud a whistleblower exposes is a key factor in determining the amount of the whistleblower’s reward.
• The Value of the Information Provided – The value of the information provided in a whistleblower claim is a key factor as well. Generally, the more information a whistleblower provides, the larger the reward the whistleblower will be entitled to receive.  
• The Level of Assistance Provided – Along with the value of the information provided in a whistleblower’s initial complaint, the level of assistance the whistleblower provides during the government’s healthcare fraud investigation can also greatly impact his or her reward amount if the case is successful..
• Whether the Government Intervenes – If the government decides to intervene in a qui tam lawsuit, the whistleblower will generally be entitled to between 15% and 25% of the funds recovered if the case is successful. If the government declines to intervene, this increases to between 25% and 30% of the amount recovered.
• The Importance of the Case for Combating Health Care Fraud and Protecting Medicare Beneficiaries – The importance of the case to the government’s overall enforcement efforts can also play a role in calculating a whistleblower’s reward under the False Claims Act. If a particular fraud scheme is an enforcement priority for the government, this can play a role as well.

Engaging a Law Firm to Assist You with Reporting Fraud as a Medicare or Medicaid Whistleblower

If you are interested in seeking a monetary award for exposing Medicare fraud to the federal government, you will want to have an experienced whistleblower law firm on your side. Here are just some of the ways our law firm can assist you:

• Determining if You Are Eligible to Seek a Whistleblower Reward – If you have information about a healthcare provider submitting false claims or fraudulently billing Medicare through other means, our attorneys can determine whether you are eligible to come forward under the False Claims Act and seek a whistleblower reward.
• Helping You Make an Informed Decision About Coming Forward – If you are eligible to come forward and seek a whistleblower reward, we can help you make an informed decision about whether you are prepared to serve as a federal whistleblower.
• Filing a Qui Tam  Lawsuit Under the False Claims Act – If you decide to come forward, our experienced whistleblower attorneys will prepare and file your qui tam lawsuit under the False Claims Act.
• Enforcing Your Rights Under the False Claims Act – If you become eligible to receive a reward, we can work to secure an appropriate reward amount based on the specific circumstances of your case. We can also enforce your rights under the FCA’s anti-retaliation provisions if you experience employer retaliation after coming forward.
• Working with the Federal Government on Your Behalf – Throughout the process, our attorneys will work with the federal government on your behalf. We have a proven track record of representing whistleblowers in cases involving fraudulent billings related to federally funded healthcare services and programs.

FAQs: Reporting Medicare and Medicaid Fraud Under the False Claims Act

Schedule a Free and Confidential Consultation with an Experienced Whistleblower Attorney at Oberheiden P.C.

If you are interested in filing a whistleblower complaint and seeking a Medicare whistleblower reward, we encourage you to contact us promptly for a free and confidential consultation. To speak with an experienced whistleblower attorney at Oberheiden P.C. as soon as possible, call 866-320-3959 or tell us how we can reach you online now.