On behalf of Brewer, Pritchard & Buckley, P.C. posted in false claims/qui tam claims on Friday, October 19, 2018.
When when there is an accusation by the Texas government or federal government that a health care provider has been engaging in illegal activities related to it, it will pursue them and penalize them. This is to stop fraud and punish those accused of committing it. Often, the foundation of the case stems from information provided by a whistleblower. For companies that are facing accusations in this regard, part of the defense is to know what whistleblower protection is available to the provider of information as this can be an integral factor in the defense.
In general, qui tam claims are made by an employee who alleges that a company has committed fraud against the government. Since it can negatively impact a worker who is aware of these alleged behaviors to report it, these people are granted whistleblower protection. A justification for the qui tam claim being done anonymously is to protect the whistleblower. Eventually, the person’s identity will be revealed one way or the other. Management might be accused of threatening or harassing the employee who reported the alleged wrongdoing. It can result in demotions, abuse and termination.
Employers are barred from taking these actions under the False Claims Act. The employee must show that he or she was retaliated against for reporting the information. The following must be in place for there to be retaliation shown: the employee took part in activities that are shielded under the False Claims Act; the employer was aware of the qui tam; and the employer committed retaliation. If it is found that the employee’s rights were violated under this law, the employer can get his or her job back and be treated as if this never happened. There can be other compensation due to the employee.
Employers who are accused of violations under false claims/qui tam claims will have their reputations severely damaged and face other consequences. Simply by being accused of these legal violations, the government might try to extract confessions of wrongdoing on the part of medical providers even if they have done nothing in violation of the law. Such accusations as double billing, billing for goods and services that were not provided, false contractual claims, Medicare and Medicaid fraud and more are frequently part of these cases. The employee making the accusations might not be telling the whole truth or it could be a misunderstanding. A law firm that is experienced in these cases should be contacted to provide a defense.