In What Situations Would Healthcare Whistleblowers File a Qui Tam Lawsuit?
A healthcare whistleblower may file a qui tam lawsuit against a corporation that defrauds the federal government or a state government. This type of lawsuit recovers government funds against the corporation that committed the fraudulent practices. Under the False Claims Act, the whistleblower is given a monetary incentive for filing and successfully resolving a lawsuit challenging the fraudulent practices. The incentive amount is a specified percentage from the recovered amount.
What Would Motivate Healthcare Whistleblowers to Bring a Qui Tam Action?
Generally, healthcare workers have a high respect for their profession and are disgusted to discover healthcare companies cheating the government. Whistleblowers in the healthcare industry often require no external motivation to report fraudulent healthcare practices. However, the financial incentive, which compensates whistleblowers that file and successfully resolve qui tam actions, encourages and supports whistleblowers that come forward to speak out against fraud.
Types of Healthcare Whistleblowers
Because of the enormous scope of government healthcare programs, most healthcare workers will at some time participate in or observe a government healthcare program. Where fraud is uncovered, healthcare workers are in a unique position to file a qui tam lawsuit to recover government funds on behalf of all taxpayers.
- Pharmacists as Healthcare Whistleblowers
Pharmacists are an integral part of the healthcare industry and are responsible for accurately filling prescriptions and supplying information to patients about their medication. Pharmacists are also in a unique position to observe healthcare fraud. Numerous successful whistleblower cases have been initiated by pharmacist whistleblowers.
- Physicians as Healthcare Whistleblowers
In many cases, physicians have unrestricted to access to patient data and possibly operational and financial figures. Physicians also have first-hand information from their colleagues and staff regarding day to day healthcare practices. With access to so much information, physicians are in a position to identify fraudulent healthcare practices taking place within their office, organization, or industry-wide. Further, their position of power, coupled with their patient and staff relationships, makes it possible to identify the necessary evidence for a successful lawsuit. Because of their position and reputation, physicians can provide a great amount of credibility and value to a whistleblower suit.
- Employees as Healthcare Whistleblowers
Administrative and staff employees have access to a vast array of healthcare and patient information through their superiors, processing paperwork, and working closely with other employees. In many cases, healthcare employees can readily identify evidence and even first-hand testimony involving a fraudulent scheme. Many successful qui tam lawsuits were filed by administrative staff that identified fraudulent practices occurring at their place of work.
- Contractors as Healthcare Whistleblowers
The healthcare industry relies on contractors and subcontractors to perform a substantial amount of healthcare work. As a result, contractors may observe vital information during interactions with staff employees or through standard office procedures. Contractors can file a whistleblower suit if they identify or witness fraudulent activity.
- Industry Experts as Healthcare Whistleblowers
Industry experts perform a huge amount of work in the healthcare field. Companies often hire or contract with industry experts, consultants, and other 3rd parties to support patient health, identify best practices, streamline operations, and outline strategic initiatives. It is no wonder that in the course of their work, fraudulent practices may be uncovered. If the numbers and figures do not add up, healthcare industry experts may have identified healthcare fraud.
Healthcare Whistleblower Representation
Behn & Wyetzner attorneys are qualified to assist any healthcare whistleblower in determining their legal options. If you have information on fraudulent healthcare practices it is important that you work closely with a qualified attorney to report any false claims to uphold the integrity of your case and protect your own legal rights.