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Whistleblower Options:  Hotlines vs Qui Tam Suits

11/4/2015

 
If you want to report your employer for Medicare or Medicaid fraud, you can call a government hotline or you can file a whistleblower lawsuit.  Here are some pros and cons for both options.

Calling a hotline is relatively easy and requires very little commitment.  You pick up the phone, call a government agency such as the Office of Inspector General at the Department of Health and Human Services, and tell the person at the other end of the line what you know.  You can report the fraud anonymously.  You do not have to worry about your employer finding out that you reported them to the government for fraud..

The problems with a hotline are: (a) your call by itself will not result in an investigation; and (b) you have no way of knowing what, if anything, was done in response to your call.

A single phone call to a government hotline will not lead to an investigation.  Government hotlines get so many calls every day that they cannot possibly investigate every call.  Anonymous tips, in particular, will not start an investigation because the government has no way to determine whether your tip is substantiated or you are just a disgruntled employee or competitor.  The most you can hope for when calling a hotline is that many other people will call with the same complaint against the same employer.

A more effective option is to commence a whistleblower lawsuit.  This requires a greater commitment on your part, but it is much more effective.

The False Claims Act allows individuals to file lawsuits on behalf of the government and share in any recovery.  Your lawyer will file the lawsuit "under seal" (i.e., in secret) and will provide your evidence to the government.  Once the lawsuit is filed, the government must investigate your claims.

If the government needs more than 60 days to investigate your claims, it must ask the Court to "extend the seal" on the case.  The government lawyers must inform your lawyer that they intend to ask the Court for more time, and they will usually brief your lawyer on the status of their investigation.  Your lawyer can also follow up with the government's lawyers throughout the process for updates.

Here's the best part.  If the government recovers money as a result of your whistleblower lawsuit, you are entitled to a reward of between 15% and 30% of the amount recovered.  In Medicare and Medicaid fraud cases, the rewards can be very large.  Many whistleblowers receive hundreds of thousands of dollars in rewards.  Some receive millions of dollars in rewards.

If you have evidence of Medicare or Medicaid fraud, you should consult with an experienced whistleblower lawyer immediately to protect your rights.  The consultation is free and completely confidential.  If you and your lawyer decide to proceed with the case, it will be handled on a contingency fee basis -- there are no legal fees unless you win.

To schedule a confidential consultation with an experienced whistleblower lawyer, call John Howley, Esq. at (212) 601-2728.

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