As the numbers of Medicare and Medicaid patients expands, so does the potential for fraud and waste. The cost to oversee these programs is extensive. Funding and manpower are not available to examine every hospital charge for patient care, procedures, pharmaceuticals and supplies. It's no wonder that tens of millions of dollars are wasted every year in Virginia (VA), Washington, DC and in other states, counties and cities across the country. Further, there are companies that dream up scams, devices and programs that fraudulently bill or make claims on the government also. As false claims and scams increase, so does the need for attorneys to engage in suits to recover some of the taxpayer waste and to help put a stop to the abuse. Not only can these scams affect Medicare/Medicaid, but this article covers any other form of retaliation against employees that report fraud or billing abuses affecting federal government programs.
Blowing the whistle on a company that is defrauding the government is extremely important and far too many employees fail to do so out of fear of retaliation by their employer. This is when your company finds out you’re helping the government and they decide to terminate your employment, demote you, or take some other retaliatory action believing that you may report the truth about an illegal practice.
If you’ve been the victim of employer retaliation, you have federal law legal protections and can pursue compensation relating to the retaliatory act, potentially separately from an action called a "whistleblower claim" discussed in a separate whistleblower protection article. To prevail in a retaliation case you need to prove three things: (1) that you were complying with the False Claims Act/FCA and providing information to the government, (2) the employer knew you were part of a qui tam case or assisting the government in investigating the fraudulent activity and (3) the employer took action against you because of your choice to reveal the illegal activity.
Some courts require you to take affirmative steps to show you were in a qui tam case or assisting in a government investigation. Otherwise, there might be no connection between the employer's retaliatory action and the fraudulent activity you are making known or reporting. For example, the company may defend against your retaliation claim by asserting that there is a substantial reason, other than knowledge of fraudulent activity, for their actions against you. Other obstacles to a retaliation claim or suit would be that you must show economic loss or harm and that you are within the statute of limitations (i.e., the timeframe in which you can file a retaliation claim).
Retaliation claims can be filed along with a qui tam whistleblower case in court. However, qui tam cases can only be settled with the consent of the US government, which can hold up settling the retaliation claim for their investigation.
Determining whether or not you should file a retaliation claim is extremely important and you should consult with an experienced attorney right away to discuss what legal option is best for you and your family. These cases can be very complex and you need to be informed of all that will come with filing either a retaliation claim and/or a qui tam/false claim act case.