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Whistleblower Attorney and False Claims Act Representation

Whistleblower Attorney & False Claims Act (FCA) Representation?

Do you suspect that your employer is engaging in fraud against government programs? 

You should speak to a whistleblower attorney about what you’ve witnessed. While you’re waiting to hear from your lawyer, it may help you to understand some of the issues involved in cases like these. 

This guide will help you understand the laws around whistleblowing and how a lawyer can help.

You’ll learn: 

  • What is a whistleblower & the False Claims Act?
  • What is Medicare fraud?
  • Does Texas have Medicaid whistleblower laws?
  • What can a whistleblower attorney do for you?

First, you should understand what it means to be a whistleblower and what role the False Claims Act may play in your case.

What’s a whistleblower & what is the False Claims Act?

A whistleblower is someone who provides information about a business, organization, or government department. Whistleblowers play an important role in the law by revealing this fraud and ending abuse. 

The False Claims Act (FCA ) is a piece of legislation that deals with fraud against government programs. It dates back to the Civil War when Lincoln signed it to address fraud being committed by Union Army suppliers.

The FCA provides enhanced rewards for whistleblowers who reveal fraud against government programs. One of the chief ways it accomplishes this is through a qui tam provision.

The qui tam provision allows those who reveal the fraud to claim a share of recovered funds or penalties. If you blow the whistle on fraud against the public, you may be allowed to claim a portion of settlements that sometimes range into the hundreds of millions of dollars.

Many government programs are targeted for fraud.  

  • Medicare
  • Medicaid
  • Tricare
  • Military Contracts
  • Grant Programs
  • Procurement
  • Emergency & Disaster Relief

Medicare is one of the programs that is targeted most often. 

What is Medicare fraud?

Medicare fraud refers to schemes that are used to collect payments from the Medicare program illegitimately. Medicare fraud whistleblower lawyers focus on helping the people who are revealing these schemes.

Medicare fraud may be carried out by doctors, small clinics, ambulance services, or even large chains of hospitals. In the past, Medicare fraud has been committed through the use of:

  • False documentation: Any alterations of documents to increase payments or to create eligibility for payments may be considered Medicare fraud. 
  • Anti-kickback violations: Healthcare providers are not allowed to take kickbacks from the makers of pharmaceuticals, medical devices, or other treatments they provide. Accepting any favors from manufacturers may constitute Medicare fraud.  
  • Pharmacy fraud: Fraud claims against pharmacies have included off-label marketing, pricing manipulation, and rebate schemes.
  • Billing schemes: Medicare has been targeted with many billing schemes, including falsifying documents, billing for services not provided, and bundling and unbundling violations 

This is not a complete list of all the types of Medicare fraud that have been prosecuted in the past. Other fraud laws may apply in states. Texas has its own set of Medicare and whistleblower laws.

Does Texas have Medicaid whistleblower laws?

Yes, Texas has passed a series of acts that may be involved when people choose to blow the whistle on fraud against federal programs. The first of these acts is the Texas Whistleblower Act (TWA).

The TWA is meant to shield public employees from retaliation. It offers them reinstatement, compensation for lost wages, and other protections if they blow the whistle on fraud.

The other major piece of legislation is the Texas Medicaid Fraud Prevention Act (TMFPA). 

What is the Texas Medicaid Fraud Prevention Act (TMFPA)?

The TMFPA broadly targets Medicaid fraud in Texas. This act makes it illegal to submit false claims to the state program. It also exposes anyone who receives bribes liable for damages.

Like the federal law, the TMFPA offers a qui tam provision to allow whistleblowers to sue on the government’s behalf. It also establishes their right to a percentage of funds recovered. The fines that may be imposed are significant.  

What are the different fines under TMFPA?

Anyone who is found to have committed fraud against the Texas Medicaid program may face:

    • Damages measuring up to 3x the amount defrauded from the state
    • Fines between $5,500, and $11,000 for each violation
    • Adjusted penalties of up to $15,000 if an elderly person was harmed by the fraud

Whistleblowers can receive a percentage of these funds. 

Texas whistleblower rewards and other considerations

The award for blowing the whistle on fraud depends on whether the government participates in the case. 

If the government assists with the prosecution, the whistleblower may be entitled to as much as 15-25% of funds that are recovered. If the government abstains and the whistleblower proceeds alone, they may receive between 25-30%. 

Texas whistleblowers may receive up to 5% of any administrative penalties that are applied in cases of fraud or abuse of funds. A Medicare whistleblower attorney can help you begin one of these cases.

What can a whistleblower attorney do for you?

A whistleblower can help you with every stage of a case. Depending on where you are right now, a lawyer may be able to help you:

  • Evaluate a claim & determine if it constitutes fraud
  • Help you gather evidence
  • File the original claim and lawsuit
  • Try the case in court
  • Fight for the maximum reward for any claim
  • Protect yourself from retaliation 

Attorneys representing whistleblowers may be able to support you in many other ways that are specific to your case.

Is it time to call a lawyer about blowing the whistle?

If you are aware of fraud against government programs in Texas, you should speak to a lawyer about blowing the whistle. Now, you’re in a better place to understand what fraud is, how some federal and state laws apply to it, and how a lawyer can help you. 

Use this knowledge to consider what topics you should cover during your first consultation with your lawyer. A whistleblower attorney can answer any remaining questions you have.  

 

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