What could be more uncomfortable than discovering your employer is defrauding the government? Knowing that your employer is upcoding patients or turning in false invoices to the government for payment puts an employee in an impossible position.

Do I report it internally and risk being fired?
Do I keep quiet and become complicit in a possible crime?
If I want to do the right thing and report it to the government, who do I contact?

Blowing the whistle on government fraud is a hard thing to do because all of your options may initially seem bad. You know the company is stealing and you don't want to be a part of it. But you know that reporting the wrongdoing may put your career at risk. 

You are right to be concerned. Being a whistleblower is a tricky business. You have to be smart and you need to know exactly what your rights are as soon as possible and preferably before you take any action. 

The False Claims Act is a federal law that allows people who are not affiliated with the government to file actions against federal contractors claiming fraud against the government. The act of filing such actions is informally called "whistleblowing." Persons filing under the Act stand to receive a portion (usually about 15-25 percent) of any recovered damages. The Act provides a legal tool to counteract fraudulent billings turned in to the Federal Government. Claims under the law have been filed by persons with insider knowledge of false claims which have typically involved health care, military, or other government spending programs.

The provision allows a private person to bring a lawsuit on behalf of the United States, where the private person has information that the named defendant as knowingly submitted or caused the submission of false or fraudulent claims to the United States.  The False Claims Act, passed by Congress on March 2, 1863, was an effort by the government to respond to entrenched fraud where the official Justice Department was reluctant to prosecute fraud cases. Importantly, a reward was offered in what is called the "qui tam" provision, which permits citizens to sue on behalf of the government and be paid a percentage of the recovery. The False Claims Act provides incentive to relators by granting them between 15% and 25% of any award or settlement amount.  

Whistleblower/qui tam claims result from fraud in a number of different areas, including:

  • Procurement fraud
  • HUD fraud
  • Medicaid fraud
  • Airport Construction
  • Medicare / Tricare fraud
  • Energy contract fraud
  • Defense Contractor fraud
  • Government Health Insurance fraud
  • Building and Roadway Construction    
  • Public works projects and federal government construction

One area in which qui tam claims are growing is the health care industry. When an employee has knowledge of fraud involving Medicare, pharmaceutical misconduct or other activity involving government reimbursement or payment for health care, they should speak to a qui tam lawyer for assistance as soon as possible.

Whistleblowing is a difficult step to take in terms of an employee's career. Anyone thinking about blowing the whistle needs to be careful and to get educated on the applicable law as soon as possible.