Healthcare employees play a critical role not just in patient care, but in ensuring that the medical system operates ethically and legally. If you’ve been asked to falsify records, submit false claims, or participate in unethical practices involving government-funded programs like Medicare or Medicaid, you have the right to take action against your employer—and potentially receive a financial reward for doing so.
The False Claims Act (FCA): A Legal Path to Hold Employers Accountable
The False Claims Act (FCA) is a federal law that allows employees to report fraud against the government. Under the FCA, employees can file lawsuits directly against their employers for fraudulent claims submitted to the government. These lawsuits, known as qui tam actions, allow whistleblowers to hold their employers accountable for illegal actions, even if the government chooses not to intervene in the case.
How You Can Benefit as a Whistleblower
Employees who successfully file a qui tam lawsuit under the FCA are entitled to a percentage of the government’s recovery, regardless of whether the government intervenes in the case.
- Government Intervenes: Whistleblowers (known as relators) can receive 15–25% of the total recovery.
- Government Does Not Intervene: If you proceed on your own, you can receive 25–30% of the recovery for taking on the case.
Given that healthcare fraud cases often involve millions of dollars, the potential rewards for whistleblowers are substantial.
Examples of Fraud That Employees Can Report
You may have a claim if your employer has:
- Falsified Patient Records: Documenting false diagnoses, treatments, or hospice eligibility to qualify for Medicare/Medicaid payments.
- Submitted False Claims: Billing for services not provided or procedures that were unnecessary.
- Engaged in Kickback Schemes: Accepting or offering bribes in exchange for referrals or using specific services/products.
- Avoided Repaying the Government: Failing to refund overpayments or improperly retaining funds owed to Medicare/Medicaid.
Your Protections as a Whistleblower
The FCA not only rewards whistleblowers, but it also protects you from retaliation. Employers are prohibited from firing, demoting, harassing, or taking any adverse action against employees who report fraud or refuse to participate in illegal activities. If you experience retaliation, you may be entitled to:
- Reinstatement to Your Job
- Double Back Pay with Interest
- Compensation for Emotional Distress and Legal Fees
Steps to Take If You Witness Fraud
Document the Fraud:
- Collect evidence, including emails, instructions, or records showing fraudulent practices.
- Keep this information confidential and secure.
Consult an Attorney:
- Speak with an attorney experienced in False Claims Act cases to understand your options.
- They can help you file a qui tam lawsuit while protecting your rights.
File a Qui Tam Lawsuit:
- Your attorney will file the complaint under seal in federal court and submit evidence to the Department of Justice (DOJ).
- Even if the government does not take over the case, you can pursue it independently and still receive a portion of the recovery.
Why Filing a Claim Matters
Fraudulent practices not only waste taxpayer money but also harm patients and undermine trust in the healthcare system. By filing a lawsuit, you are not just protecting your professional integrity—you’re standing up for ethical care and helping to ensure that government programs like Medicare and Medicaid remain viable for those who truly need them.
Contact Us to Protect Your Rights and Pursue Justice
At The Vargas Law Office, we are here to support healthcare employees who have been asked to participate in or witness fraud. Filing a claim against your employer may seem daunting, but with the right legal team by your side, you can make a difference—and be rewarded for your courage.
Contact us today to learn more about your rights and options:
- Phone: (956) 287-3743
- Website: thevargaslawoffice.com
Your voice matters. Together, we can fight fraud, hold employers accountable, and protect the integrity of our healthcare system.
