Articles Posted in Whistleblowers and Qui Tam Lawsuits

max-bender-262783-unsplash-copy-300x199On December 21, 2018, the Department of Justice released its statistics for Fiscal Year 2018 for actions taken under the Federal False Claims Act. The news release listed several notable cases and provided daunting statistics regarding the scope of fraud committed against the government in our country.

Federal False Claims Act

The Federal False Claims Act is a law that allows the government to go after both companies and individuals who file false invoices or claims in order to get paid by the government for services or products. The law also allows “relators” to recover from those who defraud the government as an incentive to citizens to help the government curb fraud and abuse in government programs.  Relators can receive up to 30% of the recovered proceeds through “qui tam” lawsuits.

igor-ovsyannykov-252342-unsplash-copy-300x200The Occupational Safety and Health Act was passed in 1970 and created the Occupational Safety and Health Administration (OSHA) to protect employees from dangerous working conditions and to standardize workplace safety. Over the years, it has been amended many times and now includes provisions that protect employees from retaliation from their employers when they either report injuries under the OSHA reporting requirements or if they file a complaint against their employer for a violation of OSHA standards. Many states have a state version of OSHA and, in the case of California, have state laws that prohibit retaliation against whistleblowers, as well.

What Conduct is Prohibited by Federal OSHA Whistleblower Laws?

Simply put, an employee is protected from “adverse actions” if they avail themselves of the rights guaranteed by OSHA. Adverse actions can include:

jonathan-perez-409943-copy-300x200A doctor was arrested on December 13, 2018 for improperly distributing opioids to his patients and billing Medicare for the drugs. The doctor now faces 45 federal charges relating to healthcare fraud for not only prescribing illicit drugs to patients but requiring those with insurance to accept injections so that he could bill additional costs to public health programs like Medicare. While this is an extreme example of pharmaceutical fraud, there are numerous smaller incidents of pharmaceutical fraud that take place every day. If you believe your employer or healthcare provider is engaging in pharmaceutical fraud or any type of healthcare fraud, contact the qui tam attorneys at Willoughby Brod immediately to report the fraud.

What is Pharmaceutical Fraud?

Pharmaceutical fraud involves illegal actions that pharmaceutical companies engage in that violate the False Claims Act (FCA) or California False Claims Act (CFCA) and result in false claims to insurers and Medicare/Medicaid.

daniel-frank-201417-copy-300x200One mistake that many Medicare recipients make is assuming that all their basic medical needs are covered under Medicare. In fact, there are a lot of commonly needed medical services that Medicare does not pay for. By becoming informed about the coverage gaps in your Medicare policy, you are not only preventing yourself from any surprises when you receive your healthcare bill, you are also increasing your ability to detect any fraudulent billing schemes from your healthcare provider or anyone else who tries to tell you that services not covered by Medicare are actually covered. If you do detect any violations by your healthcare provider or employer relating to Medicare billing, contact the whistleblower attorneys at Willoughby Brod immediately.

Dental Care

Even though every individual requires regular dental cleanings, and many Medicare recipients find themselves requiring dentures, Medicare does not pay for these basic dental needs. The only dental care that Medicare may pay for is dental care required while hospitalized as a result of an emergency.

kyle-glenn-629501-unsplash-1-copy-300x200As a whistleblower who has filed a qui tam case, your goal is to convince the government to prosecute your case. However, this is usually not an easy task. In fact, there are many situations in which the government may choose to dismiss your False Claims Act (“FCA”) claim, and the Department of Justice (“DOJ”) has outlined seven circumstances under which your qui tam claim may be dismissed. If you believe you have a strong qui tam claim, contact the qui tam attorneys at Willoughby Brod today to learn more about the strength of your case and your options moving forward.

False Claims Act

Section 3730(c)(2)(A) of the False Claims Act provides the following: “The Government may dismiss the action notwithstanding the objections of the person initiating the action if the person has been notified by the Government of the filing of the motion and the court has provided the person with an opportunity for a hearing on the motion.”

chris-greenhow-662446-unsplash-copy-300x225While whistleblowers sometimes get a bad rap as “snitches,”the opposite in fact is true. By revealing their employers’ illegal actions, whistleblowers help society in ways that only whistleblowers can. If you have any doubts about whether you should blow the whistle on your employer’s illegal actions, contact the whistleblower attorneys at Willoughby Brod today to learn more about the ways in which whistleblowers help society and the ways in which you can contribute to that cause.

  1. Whistleblowers help citizens save money.

From 1986-2016, recoveries made from whistleblower cases under the False Claims Act alone totaled over $28 billion. That is $28 billion that could have ended up in the hands of fraudsters rather than back in citizens’ pockets. By blowing the whistle on fraudulent acts, whistleblowers not only protect those who are directly harmed by the fraud but also send a message to fraudsters that the actions they wish to engage in are unacceptable and will not go undetected.

jonathan-perez-409943-copy-300x200One of the most common types of healthcare fraud in violation of the False Claims Act (FCA) is pharmaceutical fraud. It is also one of the most highly reported types of healthcare fraud, with over $4.5 billion of financial penalties issued from qui tam lawsuits in 2012 alone. While whistleblowers are important to the healthcare industry in general, it is clear that their contribution to the pharmaceutical sector has been huge. If you suspect that you have witnessed pharmaceutical fraud, contact the qui tam attorneys at Willoughby Brod today to learn more about your options moving forward.

What is Pharmaceutical Fraud?

Pharmaceutical fraud involves illegal actions that pharmaceutical companies engage in that violate the FCA or CFCA and result in false claims to insurers and Medicare/Medicaid. There are several predominant types of pharmaceutical fraud, which are highlighted below.

rene-bohmer-430927-unsplash-copy-200x300One common concern that holds people back from becoming whistleblowers is the fear that they will face discipline for being involved in the same fraud they are now reporting. Sometimes employees feel coerced by their employer into partaking in fraudulent actions, and other times the employee may have been the one to spearhead the fraud. In both cases, if you have had a change of heart, and not only do you no longer wish to participate in the fraud, but you want to put an end to it altogether, contact the qui tam attorneys at Willoughby Brod today to learn more about what steps you should take next.

When You Participated in the Fraud but Did Not Spearhead it

Both the False Claims Act (FCA) and the California False Claims Act (CFCA) want to afford whistleblowers the maximum protection possible so as not to deter people from coming forth as a whistleblower. Therefore, in most circumstances, a whistleblower who partook in the fraudulent act they are now reporting will not face any penalties for participating in the fraud.

dylan-nolte-576808-unsplash-copy-300x200Whistleblowers are one of the most misunderstood groups of people out there. From an outsider’s perspective, it can be difficult to understand why someone would want to be a whistleblower – and that is the first problem. Whistleblowers hardly ever choose to become whistleblowers. They happen to encounter situations that, in their mind, call for a solution that will promote justice and better society. If any of the myths below resonate with you, read on to find out why it is a myth, and what the truth really is.

Myth #1: Whistleblowers are disloyal.

Oftentimes, whistleblowers are referred to as “snitches” and disloyal employees, but quite the opposite is true. Whistleblowers are oftentimes the most loyal employees at a company.

benjamin-child-90768-300x200Reporting your boss for engaging in unlawful conduct at work not only requires courage but also thick skin. While some will undoubtedly tout you as a hero as soon as you blow the whistle, others may not be as friendly or supportive. You should prepare yourself for the worst, from your employer as well as from the public, should you decide to blow the whistle on your employer. Despite the risks of whistleblowing outlined below, however, remember that you are contributing to justice and ultimately contributing positively to society when you report illegal conduct. If you are unsure, nervous, or scared about how best to proceed, speak with one of the lawyers at Willoughby Brod, and they will be able to help you decide what is best for you.

Employer Retaliation

The biggest risk of whistleblowing is employer retaliation. California law prohibits any form of employer retaliation toward whistleblowers, but many employers try to do it anyway. Many think that if they do it in subtle ways, like slowly pushing the employee out of their role or finding another reason to demote them or decrease their pay, that there will be no consequences to them. From an even less straightforward angle, employers and fellow employees may start to become hostile toward the employee, spreading rumors about the employee, scheduling meetings only when the employee is unavailable, or ignoring the employee in social settings. However, this type of behavior is illegal. If you have been retaliated against by your employer, contact our attorneys immediately so that we can help you fight for your rights.