What Is a Whistleblower Complaint? What Makes It Okay?

Black whistle

If you know that a company or an individual within an enterprise is engaging in fraudulent acts against the United States government you can expose their conduct under the False Claims Act (FCA), which can be used to protect and reward you as a whistleblower.

Coming forward to report a company’s illegal or unsafe conduct is the right thing to do—it makes sure that money often intended for society’s most vulnerable families and individuals, does not go into the pockets of dishonest people. Still, being that person who figuratively blows the whistle on fraud can be unnerving. It can also have consequences for you and your family, so it’s best to arm yourself with the facts before exposing a company’s illegal or harmful behavior.

Blowing the Whistle on Fraud Benefits Your Community and Your Country

Knowing what a whistleblower complaint is, and refusing to turn a blind eye to fraud, does make a difference. Last year, the Justice Department recovered more than $4.7 billion in FCA cases and many have benefited from these funds—low-income families insured by federal healthcare programs, the elderly, veterans, families who can afford homes, and students who can now attend college thanks to federally insured loans.

Doing the right thing isn’t always easy, but it can be immensely rewarding to know that you have contributed to a more honest and prosperous society.

If you would like more information about how you as a whistleblower can be protected and rewarded, you can download our Essential Guidance On Qui Tam and Whistleblower Lawsuits. This helpful guide includes key terms, common types of Medicaid and Medicare fraud, negative consequences for whistleblowers, and a fraud checklist: if you suspect fraud, what do you do next.

How Are Whistleblower Complaints Handled?

The complaint and a written disclosure of all information is served on the US Attorney for the judicial district where the qui tam was filed, and on the Attorney General of the United States.

All complaints are sealed for 60 days. During this time the government must investigate the allegations in the complaint. If the government can’t complete the investigation in this time, it can extend the seal period while it continues to investigate. Once the investigation has been completed, the government notifies the court that it intends to go ahead with the action or that it will not proceed with the action. The person who brought the complaint can then go ahead with the action if they choose, as long as they have government consent.

Is There a Reward for Making a Whistleblower Complaint?

Whistleblowers who file a qui tam action could be eligible for a reward. This will depend on whether or not a claim is successful. If it is successful, the reward is between 15 and 30%. An employer might also be required to reinstate an employee who was fired as a result of a whistleblower complaint or require the employer to pay the employee double pay or damages for the cost of litigating the claim.

Does Your Complaint Qualify as a Whistleblower Complaint?

The False Claims Act—you might also have heard it called “Lincoln’s Law”—allows you to sue in what is called a qui tam action on behalf of the Federal Government for fraudulent acts committed against the government. Even though Mississippi does not have a state FCA, if you have witnessed fraud, waste, or abuse affecting either the state or federal government, you can file a whistleblower lawsuit under the qui tam provisions of the federal FCA.

Types of violations under the False Claims Act include:

Billing fraud—knowingly billing for products, services, or work that was never carried out or delivered; overcharging for goods or services; or misuse of coding in order to fraudulently charge for products or services.

Medicare/Medicaid fraud—performing procedures in order to increase Medicare reimbursement, billing for unlicensed or unapproved drugs, and other forms of medical fraud.

Fraudulent records—submitting false service records or samples in order to show better-than-actual performance, falsifying certification of a test or standard, or falsifying records for reimbursement or monetary gain.

Equipment fraud—presenting faulty or unproven equipment as operational and tested, or billing for premium equipment while providing inferior equipment.

Product fraud—misrepresenting the value of imported goods or their country of origin for tariff purposes, or failing to report known product defects in order to continue to sell or bill the government for the product.

Miscellaneous—yield burning (skimming off the profits from the sale of municipal bonds), failure to report overpayment by the government for sale of goods or services, or contract kickbacks or bribes.

How Long Do I Have to Make a Complaint?

You have six years after the date on which the violation took place to make an FCA complaint, or three years after the date when the material facts of a violation were made known to the US official responsible for acting on the FCA violation.

How do I make a whistleblower complaint—do I need a lawyer?

Approaching a lawyer is a good idea before going ahead and reporting fraud against the government. Not only will they be able to act on your behalf, protect you from reprisals, and give you expert advice, they will also make sure that any reward due to you under the qui tam provision of the FCA, is recovered for your benefit.

Correct Reporting of Your Case Could Award You With a Percentage of the Recovered Funds

Coxwell & Associates investigates FCA cases across the state of Mississippi. If you are an employee at a facility and have witnessed any type of fraudulent Medicare or Medicaid billing, please contact Chuck Mullins at Coxwell & Associates. Report your case correctly and you could be awarded 25 to 30% of the recovered funds. We will also look at any other type of government fraud cases across the state so please reach out to us for advice.

Disclaimer: This blog is intended for general information purposes only, and is not a substitute for legal advice. Anyone with a legal problem should consult a lawyer immediately.

Related Posts
  • 4 of the Biggest Stark Law Cases Settlements Ever Recorded Read More
  • What Protects Me from Whistleblower Retaliation? Read More
  • Can a Whistleblower Be Prosecuted in Mississippi? Read More