Your Rights When Your Employer is Engaged in Wrongful Conduct

State Whistleblower Laws and Federal Qui Tam Protect Rights of Workers

Here is an interesting dilemma – What do you do if you learn that your employer is cheating Medicare or Medicaid? On the one hand, you do not want any part of the wrongful conduct. On the other hand, you may worry that if you report the conduct you may get fired, or become the target of retaliatory conduct, such as a demotion or an undesirable job assignment.

Here is the good news: State and Federal law encourage you to report Medicare and Medicaid fraud in two important ways. First, if you report the illegal conduct and your employer is required to pay back the money, you may be entitled to a significant portion of that money. Second, if you report illegal conduct of your employer, you are afforded protection from termination and retaliation.

The Federal Whistleblower Act

Any person with knowledge that another company or person is defrauding the federal government, including Medicare or Medicaid fraud, may file what is known as a “qui tam” or “whistleblower” action. By doing so, the person becomes a Whistleblower. Qui tam actions are filed under the federal False Claims Act, and can involve:

  • Medicare Fraud
  • Medicaid Fraud
  • Tri-Care Fraud
  • Kick-Backs – offering to pay someone to refer a patient or prescribe a drug
  • Fraudulently requesting payment from a federal government agency or program
  • Using a false record or forged document to obtain payment from the federal government
  • Fraudulently concealing, avoiding or decreasing an obligation to pay money to the federal government

If the lawsuit leads to the recovery of money from the employer, the whistleblower may be entitled to a significant portion of the money recovered. In a recent case involving a Mississippi hospital, an employee who reported illegal Medicaid billing practices will receive nearly $3.5 million for disclosing the wrongful conduct.

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