Blog Post

Becoming a Whistleblower is easy – if you’re fast enough.

May 3, 2021
Do you work for:
  • a pharmaceutical company that gives bribes or kickbacks to doctors or pharmacies to get them to recommend medications the company markets to Medicare recipients – like promoting illegal off-label use of a medication?
  • a pharmacy chain that overcharges government health care programs (such as Tricare or Champus) for medications or medical supplies?
  • a hospital chain that submits false cost reports to Medicare or other federal programs in order to increase its profits?
  • a hospice or home health company that gives bribes or kickbacks to doctors, nursing homes, or assisted living facilities to get patient referrals?
  • a company that supplies material, parts, hardware, software, or labor to the government and lies about what it’s providing in order to increase its profits?
  • any other company that isn’t being straight with Medicare or another federal agency in order to make more money?
The federal government has strict rules that anyone it does business with has to follow. Simply put, if a company submits a bill to the federal government (“please pay me”) the law says the company is promising the government that it has followed all of the rules that it must follow in order to get paid. If the company lies about anything the government would consider important to its decision to pay that bill, the company can be made to pay back not just that bill, but to pay back up to three times that bill. It can also be forced to pay up to $23,000 for each fraudulent bill it submits to the government – for each and every fraudulent bill.

The federal government obviously wants people to tell it if a company is lying to it in order to get paid, because that company is in effect stealing from every American taxpayer. So the law, called the “False Claims Act,” offers a reward to whoever “blows the whistle” on someone committing fraud on the government. How much can that reward be? Since settlements of False Claims Act cases are commonly in the millions of dollars, and are regularly in the hundreds of millions of dollars, a Whistleblower reward (called an “Award”), which usually ranges from 15-25 percent of the settlement, can be enormous.

But there’s a catch: the Whistleblower has to be the first person to tell the government about the fraud. There are no “me too” Whistleblowers. That doesn’t mean only one person can be a Whistleblower (called a “Relator”), it just means that if there’s more than one Whistleblower they have to tell the government together (called being “Co-Relators”).

But you have to tell the government that it’s being ripped off before anybody else does. And you have to give the government all of the evidence you have of how the company was committing the fraud.

So what if you signed a Confidentiality or Nondisclosure Agreement with your company? Does that mean you can’t tell the government that your company is defrauding it? Since two private individuals (like a company and its employee) can’t agree to hide fraud from the government, of course you can tell the government your company is committing fraud.. Nor can the company prevent you from showing the government evidence that you as an employee have a right to see. Depending on what your company does, and what your Confidentiality or Nondisclosure Agreement says, you may not be able disclose company information that isn’t related to the fraud you’re disclosing to the government.

So what do you do if you think your company is defrauding Medicare, or another government agency?

Talk right away to a lawyer who has handled False Claims Act cases. They will be able to tell you more about your situation and what you should do.

But don’t wait. Under the False Claims Act’s “First-to-File” Rule it’s literally a race. And whoever tells the government first wins.



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