Top 9 Myths about Blowing the Whistle on Healthcare Fraud

There are tens of thousands of people who have direct knowledge of Medicare and Medicaid fraud. That means there are potentially tens of thousands of people eligible for a whistleblower award. Only a select few come forward, however. If you don’t come forward and file a False Claims Act claim, you will never get an award.

Why don’t more folks come forward? Usually it is because of misinformation! There are many myths about becoming a whistleblower… and most of those myths are simply wrong!

Myth 1: All I Need to Do Is Call a Toll Free Medicaid Hotline

There are many hotline numbers out there. The federal government operates a Medicare fraud hotline. Some nonprofit groups operate hotlines. Several states offer Medicaid fraud hotlines. Usually the most you can receive for calling a government tip line is just $1000!

To qualify for the much larger awards under the False Claims Act, you need to file a claim in federal or state court. The federal government says you need to have a lawyer. That scares away some folks but it shouldn’t.

Lawyers that specialize in these claims typically only get paid if they collect money for you. If you don’t get paid, they don’t get paid.

The toll free number operated by our group can get you connected with a qualified lawyer, knowledgeable about Medicare and Medicaid fraud (Few lawyers in the United States handle these claims) and will work on a “contingency” basis, i.e. no recovery, no fee.

The federal False Claims Act pays you up to 30% of whatever the government collects from the wrongdoer. With triple damages and penalties of up to $11,000 per fraudulent patient bill, the penalties (and therefore the awards) add up quickly. Million dollar awards are not uncommon. You don’t get these awards by simply calling a government hotline, however. You must file a claim in court.

Myth 2. My Employer Will Fire Me if They Find Out

The federal False Claims Act and most states have strong anti-retaliation provisions to protect whistleblowers. Typically, these include double lost wages and legal fees and some other money damages. Nothing can prevent you from getting fired but most employers know that firing a whistleblower only makes their problems worse.

Myth 3. My Co-Workers Will Know if I File a Medicaid Fraud Claim

Under the False Claims Act and most state Medicaid fraud whistleblower laws, the case is secret while being investigated by the government. That gives you time to find a different position or plan for the future.

The law requires the case remain secret so that the government has the time to conduct its investigation without interference from the wrongdoer. Chances are your coworkers won’t know for months and maybe years.

Myth 4. The Big Cash Awards Aren’t Real

Not true! The U.S. Department of Justice paid out over $435,000,000.00 to whistleblowers in 2014. Hundreds of people receive whistleblower awards each year.  The only reason more folks don’t receive awards is because most people do not know the best way to report.

Remember, if you call a government hotline, the most you receive is usually $1000. Whistleblowers that go ahead and file False Claims Act complaints can receive millions of dollars, however. The size of the award is based on a percentage of what the government or your lawyer collects from the wrongdoer. Submit our Online Form or give us a call to learn more about your rights.

Myth 5. Blowing the Whistle Isn’t Cool

Stealing isn’t cool and that is what Medicaid fraudsters do. They steal from hardworking taxpayers like you. Medicaid is funded with tax dollars. When someone steals from Medicaid, they are stealing from every American.

If you are still not convinced, Medicaid fraud often kills. It is dangerous. Doctors who bilk Medicaid often do so by performing unnecessary treatments or dispensing dangerous drugs without a shred of medical necessity. We have seen doctors perform unnecessary cardiac surgeries, patients hospitalized longer than necessary to increase Medicaid billings and even a physician in Detroit who told patients they had cancer when they didn’t (and treated them with dangerous chemo drugs to collect more from Medicaid and Medicare).

You didn’t choose to work for a criminal. They put you in a bad position. We believe that whistleblowers are the new American heroes. Medicare and Medicaid fraud cost taxpayers tens of billions of dollars each year. Thankfully, whistleblowers are the primary line of defense against the greed and corruption these dishonest doctors, hospitals, pharmaceutical companies and clinic owners represent.

Myth 6. I Have to Report the Fraud to my Boss First Before I Can File a Whistleblower Claim

Most people do report fraud internally first. There is no legal requirement to so, however. If telling your boss is likely to get you fired, there is no reason to wait before filing a whistleblower claim.

Many people who file False Claims Act claims do so after they were fired, demoted or harassed.

Myth 7. I Don’t Know How to Find a Lawyer or How to Go Through the Process

This is where we can be a big help. There are 1.2 million lawyers in the United States yet well less than 1% have ever filed a Medicaid fraud False Claims Act complaint and even fewer concentrate or specialize in these cases.

We can help you find a lawyer. One that understands your case. One that cares about you, understands how to deal with retaliation should it occur.

We don’t charge for our services and can find someone to answer your questions, even if you decide not to file a False Claims Act complaint or decide to anonymously report through a tip line.

Myth 8. I Can’t Become a Whistleblower Because I am a Patient 

Again, another false myth. Most whistleblowers are “insiders” but there is no legal requirement that you be an employee of the wrongdoer. Cases are often filed by former employees and patients.

The law requires that you have inside information. You acquire that if you were or are a patient and know that your healthcare provider is billing for services never performed or services not medically necessary. Upcoding evidence is often uncovered by patients as well when they receive copies of bills sent to Medicaid or Medicare.

Myth 9. I Helped my Boss Commit the Fraud, so I’m Ineligible for an Award

The Justice Department and state prosecutors want whistleblowers to come forward. If you were the mastermind of the criminal behavior or if you directly benefitted from the fraud, you may not be eligible. In most cases, the government is interested in the clinic owners and executives behind the fraud, not the front line workers forced directly or indirectly to participate.

If you were involved in the fraud, it is very important that you speak with a lawyer. They can help you know your options and your conversations with them are confidential.

Medicaid Fraud Hotline: 888.742.7248 or Report Online