Understand the False Claims Act to be a better whistleblower
Whistleblowing is a very important area of the healthcare industry. When exercised properly and with integrity, it helps expose major frauds and saves the industry from many malpractices. There have been instances of whistleblowers bringing many companies into the legal net and helping save frauds.
A whistleblower act, or what is called or qui tam action, can offer huge financial rewards to those who are retaliated against for exposing financial fraud that their company was engaged in, resulting in losses to the government. They are protected under what are called the federal and state False Claims Acts, or FCA’s. These are the primary statutes under which this relief may be sought. The False Claims Act is the law used in the health care industry to fight frauds, specifically those committed by hospitals.
Getting it right is crucial
Under the terms of the FCA’s, whistleblowers are entitled to anywhere between 15 and 25 percent of the amount recovered by the state and federal governments. The total amount these governments pay out to pharmaceutical drugs, medical devices, hospital care, and nursing home care through Medicare, Medicaid, and other programs runs into hundreds of billions of dollars each year.
Although these terms are clear, there is considerable confusion regarding various aspects of the whistleblower laws and the claims brought under the False Claims Act. On the one hand, a whistleblower action can provide financial rewards to individuals who are retaliated against for providing information that a company or individual has defrauded the government. On the other, if the government finds that the whistleblower is also part of the fraud for which the whistleblowing act took place; such a person could be named in a whistleblower civil or criminal suit.
Considering the enormity of the sums involved and the gravity of action that could follow from a false reporting, it is extremely important for professionals in the healthcare industry to be aware of the complete and proper ways in which the FCA’s work.
Understand how to get the FCA’s right
This is what a webinar being organized by MentorHealth, a highly regarded provider of professional trainings for the healthcare industry, will teach to attendees. Shauna B. Itri, who has worked on a series of False Claims Act cases against large drug companies for fraudulent Medicare and Medicaid drug pricing, will help participants understand all the important elements of the False Claims Act.
Participants will be given a clear understanding of the procedures for filing a False Claims Act case, the importance in protecting the court’s seal, and the pros and cons of bringing a case and important information that employees who want to know about the FCA’s should bring to the attention of the government and the attorney representing them.
Shauna will cover the following important areas of the FCA’s during this webinar:
o The elements of a False Claims Act case
o Types of False Claims Act cases brought in hospital and healthcare settings
o Examples of False Claims Act cases that have been successful and have recovered money for the government and rewarded whistleblowers for reporting fraud
o Tools to be used to spot a potential whistleblower case and documentation needed to report the case.