Working in a New York medical facility can no doubt be a very rewarding job. Of course, like most jobs, it likely has its challenges. Whether you just started a new position or you have been with the same company for years, maintaining a good working relationship with your employer is probably important to you. This might become quite a challenge if you suspect this person guilty of illegal activity in the workplace.
If you've seen data in office records or other questionable incidents that have led you to suspect your employer might be committing fraud, you are certainly not alone. In fact, many others in similar situations have actually come forward to report such issues. Some have then suffered further complications when their employers attempted to thwart their efforts to report fraud by threatening retaliation against them. Such acts are also illegal; thus, any employer behaving in such manner is at risk for criminal charges.
Keep alert for red flag warnings
If you're unsure whether something your employer has done constitutes fraud, reviewing the following list of top warning signs might help you clarify the issue:
- Patient data sheets appear to have been tampered with or manipulated and do not reflect accurate information.
- Billing is occurring for services that have not yet taken place.
- Evidence suggests the doctor for whom you work is receiving payment for referrals.
- Procedures are being "unbundled" on billing statements, meaning patients are being charged separately for things that should be billed under a single code.
- Patient co-pays are being waived and false claims are being submitted to cover the costs and add additional expenses as well.
These are some of the most commonly reported fraudulent acts that health care providers commit. If you've stumbled upon information you suspect is illegal and may be adversely affecting patients or the general public, you might be facing some very serious decisions.
Various options regarding employer fraud
Basically, you have several choices if you suspect employer fraud at the medical office where you work. This list is by no means extensive; so, you actually may have even more options than those listed below:
- You can do nothing and just keep on working as though you haven't noticed anything out of the ordinary.
- You can make an anonymous report of the situation.
- You can quit your job, then file a report if you're worried your employer will react negatively otherwise.
- You can keep your job and confront the situation head-on by reporting the alleged fraud and preparing yourself for whatever consequences follow.
The False Claims Act protects people from any form of retaliation in response to blowing the whistle on health care fraud in the workplace. It can be scary to address such matters without experienced legal representation. An attorney used to combating employers who try to terminate or otherwise punish employees who have reported their wrongdoing can clarify all New York and federal laws pertaining to your particular situation, can put you in contact with the appropriate authorities to report fraud and can act on your behalf throughout the process.