I Believe My Employer Has Committed Medicaid Fraud, How Do I Report It?

Reporting Medicaid Fraud for your employer

Medicaid fraud costs the government billions of dollars every year, which averts funds that are meant to be used for lawful health care services away from those who truly need them. Violations by employers may include forging prescriptions, billing for medical services not performed, and falsely filing claims, among a variety of others. Discovering that your employer is committing Medicaid Fraud may put you in an uncomfortable position. This may become a stressful situation on your behalf, but it is critical to understand that your employer is committing an illegal act and must therefore be reported. Working in the healthcare industry and finding out your employer may be committing Medicaid Fraud can be nerve-wracking as you expect them to be focused on helping clients rather than taking advantage of them. Moreover, there are several essential steps to take when approaching this situation to guarantee protection from reprisals and making sure your whistleblower claim is successful.

Reporting Employer Medicaid Fraud

Find A Qualified Attorney

The first step you should take is finding a credible attorney who has previous, successful experiences with whistleblower cases. By hiring an attorney, you will be able to consult with someone with legal expertise and can guide you in the right direction regarding the legal technicalities of your case as well as the evidence needed to ensure a victory.

Protections Under the False Claims Act

The False Claims Act is one of the strongest whistleblower protection laws in the United States. It allows someone with evidence of fraud involving programs such as Medicaid Fraud to file a claim against the offenders on behalf of the U.S. Government. The act protects employees from discrimination, harassment, suspension, or termination of employment as a result of reporting fraud. Qui tam, a subsection of The False Claims Act, allows the government to intervene and work alongside employees to investigate the offenders. According to Qui tam, the plaintiff is qualified to receive 15%-25% of the total amount recovered. To have a successful whistleblower case, as mentioned, you will need to gather proper evidence. Therefore, a credible attorney must be hired so that he/she can advise you on the appropriate steps to take regarding filing the claim.

Decide How You Will Report the Fraud

Additionally, some plaintiffs may contemplate whether it is necessary to file a claim within the company as well. If you work for a large company, there may be a direct hotline where you can submit a report, but under The False Claims Act, you are not obligated to do so. If your employer starts to pressure you, make sure to consult your attorney immediately before you take any further action.

In summary, if you believe that your employer is committing Medicaid fraud there a couple of steps you should take after making the decision to report the crime. Aside from gathering all necessary evidence to bring the most cohesive case against the defendant, your best shot is to consult with an experienced, licensed attorney who can guide you through the rough waters of whistleblower litigation, and exponentially increase the chance that not only will you come out victorious, but the perpetrator will be brought to justice.