If you've become concerned that your employer or a coworker is committing Medicaid or Medicare fraud, you may have done online research and come across the term "Qui Tam." Many times, employees discover cases of fraud are handled internally by Qui Tam lawsuits. In these cases, a whistleblower, such as yourself, who has noticed billing fraud, takes legal steps to put an end to the fraudulent practices. Unless your company offers a confidential whistleblower line to report these kinds of fraud, you may not have any options for handling it within the business.
Qui Tam lawsuits are the result. Essentially, you file a lawsuit to the government alleging fraud. Your position as an employee makes it easy for you to gather and present evidence to support your claims of fraud. If you've had this evidence reviewed by a Qui Tam attorney and he or she agrees that it is a clear case of fraud, you will typically file a Qui Tam suit under the False Claims Act.
In these cases, your employer isn't advised of the suit until the government agrees that there is fraud, which protections your job. You could receive a percentage of the amount fraudulently billed.
When should you file a Qui Tam lawsuit?
Maybe you've realized that a doctor or dentist you work for is billing for more time than is actually spent with patients. Perhaps billing codes don't match what procedures are actually performed. When you work for a medical or dental office and discover evidence of systemic fraud, it can be nerve-wracking.
How far would your employer go to cover up these crimes? Will you lose your job and be black-balled because you tried to stop it? If you can't trust your employer to do the right thing, then it's time to consider hiring an attorney who has experience litigating Qui Tam lawsuits.
Your attorney can help you file the claim, which you generally must do in a recorded environment. From there, you will need to present evidence. The records of your suit are sealed for at least 60 days to protect whistleblowers from immediate retaliation by employers.
Unfortunately, many times these cases can last months or even years. Thankfully, when the fraud is obvious, ongoing and substantial, you stand to be financially compensated for coming forward. Even if you lose your job, you can anticipate potentially recovering your losses when the Qui Tam suit is finished.
Finding the right Qui Tam attorney
The False Claims Act and Qui Tam lawsuits are very specific areas of law. Only a few attorneys have the right experience to properly represent you in these cases. Finding an attorney who has past success with these cases can improve your chances of winning the suit and putting an end to the fraud.