Many employees face a difficult decision in confronting their employer’s illegal actions. Often, an employee with knowledge of such actions must weigh the risks of retaliation against their desire to stand up against an injustice. However, when that injustice includes an employer falsely billing the federal government, potential whistleblowers may be able to take solace – as well as monetary recovery – through the protections of the False Claims Act.

False Claims Act allows U.S. Government to Recover Monies Paid as a Result of Fraud

The False Claims Act provides a mechanism for the United States Government to prosecute parties that have made a fraudulent claim for payment against it. In 2014 alone, the United States Government recovered $5.69 billion dollars arising out of actions brought under the False Claims Act.[i] While fraud against the federal government arises in many industries, the vast majority of monies recovered in 2014 came from financial institutions engaged in fraud related to federally insured mortgages and loans as well as false claims made by companies billing Medicare and Medicaid.[ii]

Whistleblowers Often Entitled to Some Monetary Recovery from Successful False Claims Prosecution

In many cases, the federal government’s ability to successfully prosecute cases under the False Claims Act is dependent on a whistleblower coming forward to expose a company’s fraud. In 2014, approximately $3 billion dollars of the total monies recovered through the False Claims Act were the result of a whistleblower coming forward (also known as “Qui Tam” claims). In addition to helping prevent fraud that burdens all taxpayers, the False Claims Act’s unique statutory structure allows whistleblowers to receive a portion of the money recovered because they exposed a company’s fraudulent billing practices.[iii] In 2014, whistleblowers received $435 million of the $3 billion dollars recovered by the federal government as a result of their actions.[iv]

For example, a case recently settled as a result of a local pharmacist alerting the federal government that her company was falsely billing Medicaid. The company agreed to pay the federal government a total of $31.5 million to settle the case. The pharmacist who alerted the government was awarded $4.3 million for her assistance in exposing the fraud.[v]

Take Action Against Fraud Under the False Claims Act

If you are aware that your company has falsely submitted claims for payment to the federal government, contact our attorneys as soon as possible to schedule a free consultation about how you can move forward under the False Claims Act.

 

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[i] Press Release, Department of Justice, Justice Department Recovery Nearly $5.6 Billion from False Claims Act Cases in Fiscal Year 2014 (Nov. 20, 2014) (https://www.justice.gov/opa/pr/justice-department-recovers-nearly-6-billion-false-claims-act-cases-fiscal-year-2014).

[ii] Id.

[iii] 31 U.S.C. § 3730(d).

[iv] See Press Release, Dept. of Justice, supra note 1.

[v] Bruce Vielmetti, Pharmerica settles whistleblower suit for $31.5 million, Milwaukee Wisconsin Journal Sentinel, May 14, 2015, https://www.jsonline.com/news/health/pharmerica15-b99500676z1-303796471.html.

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Timothy Maynard