Articles Posted in Whistleblowers and Qui Tam Lawsuits

kristina-flour-185592-unsplash-copy-300x192One of the most crucial parts of filing a whistleblower or qui tam lawsuit is evidence gathering. The more evidence you have of the fraud you are alleging, the stronger your case is and the more likely the government is to intervene. However, gathering evidence is not always as easy as it sounds. Sometimes there are crucial pieces of evidence needed in your case that you do not already have but that you have the potential to obtain. In this situation, you will want to make sure you go about collecting evidence in a lawful and ethical fashion. After all, the last thing you want is to break the law while you are reporting someone else for breaking the law.

Stay Quiet

The most important piece of advice is to stay quiet. Do not talk about the fraud you are alleging with your co-workers, friends, or family. Even though it is illegal for employers in California to retaliate against whistleblowers, plenty of employers do it anyway. Not only is losing your job during this time damaging to your personal life, but it is damaging to your case, as well. Without the access you previously had to the company, it will be nearly impossible for you to continue gathering evidence to support your claim.

joe-perales-117891-copy-300x198In general, if you want to file a lawsuit against another person or entity, you have the option of going at it alone (pro se) or hiring an attorney to represent you. While pursuing a lawsuit pro se may not be the wisest in all situations, some people still choose to go that route because it is more cost effective and they do not have to give away a portion of their winnings to their attorney. With qui tam lawsuits, however, it is almost impossible to go at it without an attorney because of how complex qui tam lawsuits are. Here are a few ways in which an experienced qui tam attorney can help you have a successful qui tam case.

Government Intervention

The most important thing you will want to achieve early on in your qui tam case is to get the government to intervene, as your case has a much higher chance of success that way. Our attorneys specialize in qui tam cases in which the government intervenes, and we will do our best to persuade the government to intervene in your case. After practicing qui tam cases for years, our attorneys have become well acquainted with government qui tam attorneys and how to communicate efficiently and effectively with them.

aidan-bartos-313782-copy-300x200As a relator in a qui tam lawsuit, you are entitled to receive up to 50% of the recovered amount under the California False Claims Act (CFCA). With such a big range of recovery, however, you may be wondering just how much you are actually entitled to receive. The factors listed below, provided by the U.S. Department of Justice, help decide your overall recovery. To learn more about your chances of recovery in your particular case, contact the California qui tam attorneys at Willoughby Brod today.

Limits of Recovery

Depending on whether the government intervenes in your whistleblower suit, you may be entitled to receive different levels of compensation under the federal False Claims Act (FCA) and the CFCA. The limits are as follows:

hush-naidoo-382152-copy-300x200With the development of big data and predictive analytics, it is easier today than ever before to detect and prevent healthcare fraud. Gone are the days of lengthy, old-fashioned investigation, and here to stay are new technologies that can identify fraudulent activities automatically and instantly. By parsing through big data and analyzing payment trends, predictive analytics softwares can identify inconsistencies in payment and seemingly fraudulent activity. This article delves deeper into the system that mines data and predicts fraud by explaining the many components that make up a fraud detection software. If you are interested in learning more about how you can use technology to detect healthcare fraud, contact our attorneys today to learn more.

Link Analysis

Link analysis focuses on measuring relationships. It mines and analyzes data relating to how individuals, healthcare providers, healthcare employees, and healthcare suppliers are related to and interact with one another. It can identify unusual interactions and even unusual identities, such as multiple or fake addresses and phone numbers.

markus-spiske-666905-unsplash-copy-300x200With about one-third of the cost of the healthcare industry in the U.S. lost to fraud, waste, and abuse, it is vitally important to society that we report healthcare fraud when we see it. While it is certainly helpful to familiarize yourself with the most common healthcare fraud schemes and pay close attention to all bills received from your healthcare provider, it is not always easy – or possible – to detect healthcare fraud with the naked eye. Thanks to technology and the development of big data, however, there are new and improved ways to detect healthcare fraud today that have never before existed. Below is a brief overview of how you can use big data to help combat healthcare fraud. If you believe you have witnessed healthcare fraud, contact one of our attorneys today to find out how you can report your claim and initiate a whistleblower lawsuit.

Common Types of Healthcare Fraud

The most common type of healthcare fraud is fraudulent billing. Healthcare providers may bill for services that were never rendered, or bill for a more expensive service than the one that was rendered. For example, a doctor might bill a patient for a two-hour visit when in fact the visit was only one hour long. Fraudulent billing in the medical space is so common that it accounts for up to 10% of annual healthcare costs in the U.S.

benjamin-child-90768-300x200The majority of U.S. states have their own version of the federal False Claims Act (FCA), and California is no exception. Anyone who engages in fraudulent activity in California may be subject to punishment under the California False Claims Act (CFCA). While the FCA and CFCA have many similarities, they have a few differences, as well, which are outlined below. If you believe your employer or another corporation is engaging in fraudulent acts, contact the whistleblower lawyers at Willoughby Brod today to learn about your options for reporting the fraud and how we can help.

Similarities Between the FCA and the CFCA

The FCA and CFCA have many similar provisions, including the following key provisions:

david-everett-strickler-196946-copy-300x195The government only chooses to intervene in whistleblower cases that it finds to be strong and in which it has an interest. By presenting your qui tam case in a strategic way, you can catch the eye of the government and encourage them to intervene. Below are several practical tips for strengthening your qui tam case and increasing your chances of getting the government involved in your case.

Gather Compelling Evidence

The most important thing the government is going to look for in your qui tam case is whether you have compelling evidence. A mere allegation alone means nothing if it is not also accompanied by hard evidence of the fraud you are alleging was committed.

israel-palacio-463979-copy-300x200While most individuals have the opportunity to bring a qui tam whistleblower suit for any violation of the False Claims Act, there are certain exceptions to who may bring a qui tam whistleblower suit and the conditions of the suit. The following are five instances that, if applicable to you, bar you from filing a qui tam whistleblower suit. If you believe any of the following may apply to you, contact an experienced qui tam whistleblower attorney immediately to find out if you fall into one of the below classes and what options are available to you.

Former and Present Members of the Armed Forces

Under the Civil Actions for False Claims Act, a former or present member of the armed forces may not, in his or her capacity as a qui tam whistleblower, sue another member of the armed forces for fraudulent actions arising out of the whistleblower’s service. Additionally, while the statute does not bar governmental employees from bringing a False Claims Act (FCA) suit, governmental employees wishing to bring an FCA suit should be prepared to respond to challenges that he or she cannot bring suit as a governmental employee.

benjamin-child-17946-copy-300x200You blew the whistle on your employer’s illegal actions, and now your employer is retaliating against you. This is not an unusual situation, but it is an illegal one. Both federal law and California law protect whistleblower employees from employer retaliation and impose large fines on employers who choose to ignore this law. If you have been retaliated against at work for whistleblowing, you may be wondering what you can do to remedy this situation. Contact the attorneys at Willoughby Brod today to have your case reviewed for free and receive actionable next steps for what you can do in this situation.

Make Sure Your Whistleblower Actions are Protected in California

California offers general whistleblower protections that protect whistleblowers from being retaliated against by their employers for disclosing or refusing to participate in suspected illegal activities, but it also offers whistleblower protections in the following specific circumstances:

ken-treloar-385255-copy-300x200Medi-Cal fraud occurs more frequently than you think and often goes unnoticed. Unfortunately, this only harms recipients and future recipients of Medi-Cal who desperately need this healthcare assistance program in order to obtain the medical treatments they require. As a whistleblower, you have the opportunity to help put an end to Medi-Cal fraud by reporting healthcare providers and professionals who engage in fraudulent acts. If you detect any fraudulent acts by your healthcare provider, contact the healthcare fraud attorneys at Willoughby Brod today to learn more about how you should proceed with your whistleblower claim.

What is Medi-Cal?

Medi-Cal is a California Medicaid program for low income adults and children that is supported by both federal and state taxes. Those who qualify for Medi-Cal can receive free or low-cost healthcare services and generally receive the same benefits offered under Covered California but at much discounted or free prices. Anyone can apply for Medi-Cal regardless of age, sex, race, religion, sexual orientation, color, national origin, marital status, disability, or veteran status.

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