When a company is defrauding the government, brave employees and others stand up for what is ethically and morally right and report the wrongdoing. These people are called whistleblowers. Whistleblowers provide an important function in our society by making sure that others are held accountable for their greed or abuse of power and cannot hide from their misdeeds because of their job titles or corporate status. Whistleblower statutes also provide job protection to whistleblowers, making the termination of a whistleblower illegal and providing whistleblowers who have been wrongfully discharged with a potential basis to sue their former employers for back pay and other damages. If a whistleblower has knowledge or evidence of fraud in the government caused by corporate malfeasance, it is very important that they quickly get strong and aggressive legal representation from experienced whistleblower lawyers.
Legal representation is critical to maximizing a whistleblower’s recovery. Many individual cases have earned whistleblowers rewards in the millions or tens of millions of dollars. If there is an issue within a company that you may feel is wrong, our whistleblower attorneys will take the time to confidentially listen to your concerns, answer your questions and help evaluate the strengths of any whistleblower claim you might have. Our lawyers at Evangelista Worley, LLC have the experience and skills in investigating and litigating corporate fraud that you need when seeking counsel for whistleblower representation. You deserve a knowledgeable team that will stand up for you. Please use the form below to contact us with any questions or concerns about a whistleblower case you’d like to discuss with one of our experienced whistleblower attorneys.
False Claims Act
The U.S. False Claims Act (FCA) is a federal statute that allows individuals, called “relators,” to file qui tam lawsuits on behalf of the government to recover funds that the government should not have paid to others. The FCA protects whistleblowers and financially rewards them up to 30% of the total amount recovered on behalf of the government. False claims may occur due to fraudulent overbilling practices, shoddy goods, improper kickbacks or undelivered services. It can occur in any industry in which the government pays for goods or services, including the health care/health insurance industry, military contracts and the financial services industry. Many states also have false claims acts to recover funds paid by the state, including state Medicaid dollars and in-state contracts.
In fiscal year 2021, the Department of Justice recovered a total of $5.6 billion in settlements and judgments, the second-largest amount recorded and the largest since 2014. The majority of this recovery – over $5 billion – was from fraud that had occurred in the health care industry. Over $1.6 billion was paid out to whistleblowers who filed suit as a qui tam relator under the FCA. In 2021, over 800 new FCA lawsuits were filed, with 598 of those brought as qui tam relators, allowing the whistleblowers to share in the recovery.
Health Care Billing Fraud
Multiple federal and state health care programs reimburse health care providers for medical services provided to those programs’ beneficiaries, including Medicare, Medicaid, the Federal Employees Health Benefits Program (FEHBP) and the Department of Defense (DOD) Civilian Health and Medical Program of the Uniformed Services (CHAMPUS/TRICARE). When a health care provider submits a claim for payment for services that were not provided or the amount charged is inflated, the health care provider submits a false claim.
Examples of false claims include when medical providers knowingly “up-code” medical services to increase the Medicare/Medicaid insurance reimbursement, unbundling services that should be bundled, or when the billed-for services are not actually provided or not medically necessary.
We assist clients alleging all types of billing fraud, including:
- Medicare Advantage fraud
- Home health care fraud
- Pharmaceutical fraud
- Prescription/pharmacy billing fraud
Government Contract Fraud
The FCA was passed in response to fraud by contractors against the federal government during the Civil War. As a result, it is often referred to as “Lincoln’s Law.” A government contractor commits a false claim, for example, when it charges for goods or services not delivered, delivers goods or services that do not meet contractual specifications, or overcharges for goods or services. The FCA has been used to recover false claims made by contractors to the DOD, the Department of Veterans Affairs (VA), the Department of Housing and Urban Development (HUD), the National Aeronautics and Space Administration (NASA) and the General Services Administration (GSA), for example. Whistleblowers reporting government contract fraud helps the government recover taxpayer funds.
Government contractors who game the system cost taxpayers billions of dollars each year. Our lawyers have a substantial understanding of the laws and tactics required to hold these parties liable for fraudulent activities.
Turn to us for sound counsel when you suspect a company provided false claims to the VA, DOD, HUD or other government agency.
The federal and some state governments have programs to encourage homeownership. The Federal Housing Administration (FHA), VA and U.S. Department of Agriculture (USDA) provide insurance for certain home loans. The federal government also promotes liquidity in the housing market by purchasing home loans through Fannie Mae and Freddie Mac. The government programs require adherence to certain underwriting standards in order to ensure the quality of the loans and reduce risk of default. When loan originators fail to adhere to those underwriting requirements, the loans the government insures or purchases are defective and are at increased risk of default. The 2007 collapse of the U.S. housing market resulted in massive losses to these programs. In response, the rules for these programs were strengthened even further. If a loan originator fails to adhere to the underwriting standards, then claims for insurance and the sale of the loan to the government are fraudulent. Lenders are required to self-audit their loan files, and, if defects are found, the lenders have an affirmative duty to report those defects to the government. Failure to do so, while certifying compliance, is also fraud on the government.
Protect Your Interests. Call Today For A Consultation.
The decision to come forward as a whistleblower is not easy. If you have questions about a potential claim, we encourage you to contact us for a consultation at no cost. We represent whistleblowers on a contingency basis, which means that we only collect attorney fees if we secure compensation for your claim. Please call 404-975-2345 or send an email to connect with our team.