You may be a witness to fraud in the health care industry. If so, you may recognize the need to report it but fear retaliation or other negative consequences if you blow the whistle.
Your concerns are completely valid. You have worked hard to gain your senior management position at a health care facility, and you do not want to do anything to jeopardize that. Fortunately, the False Claims Act is a federal law that protects you in this situation.
How long has the False Claims Act been in effect?
The False Claims Act is much older than you might think. President Lincoln signed it into law in 1863. Its purpose was to prevent fraud against the federal government because of misappropriation during the Civil War.
How does the False Claims Act apply to health care?
Understandably, a law that is over 100 years old may need some changes to keep it relevant. The False Claims Act underwent such a modification in 1986. Additional amendments applied the act specifically to Medicare or Medicaid fraud. They also redefined a violation as an act of deliberate ignorance of the truth. This means that it is no longer necessary for you to prove a specific intent to defraud the government.
What is the qui tam provision?
The qui tam provision is of particular significance to you as a whistleblower. It allows you to act on the government’s behalf to file a lawsuit against someone whom you have reason to believe has committed an act of fraud against the government.
If you file a qui tam lawsuit over a matter of health care fraud and the court decides the case in your favor, you have the right to recover a portion of the damages. The purpose of the qui tam provision is to provide an incentive that encourages you to report any fraudulent activity that you witness in the health care industry.