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How do I know if I have a whistleblower case?

Each year the Government recovers billions of dollars from successful qui tam whistleblower cases. Every successful case begins with one honest person who has the courage to come forward to report the fraud. If you believe you might have a whistleblower case, ask yourself the following questions.

1. Does your employer receive money from, or do business with, any Governmental Agency?

  • Federal, State, Local, Medicare, Medicaid, etc.

2. If so, has your employer cheated the Government in any way?

  • Over-billing, double-billing, submitting false invoices
  • Falsifying records required for payment
  • Lying about compliance with terms and condition of the contract
  • Being overpaid and not returning the over-payment
  • Knowingly delivering defective or sub-standard products or services
  • Winning a contract through kickbacks or bribes

3. Has your employer lied in order to obtain a Government contract?

  • Status as a Small Business, Minority-Owned Business, or Veteran-Owned Business
  • Qualifications to perform the contract

4. Do you work in the healthcare industry?If so, have you seen any of the following:

  • Billing for services not performed
  • Upcoding – performing one procedure then billing for another
  • Bundling or unbundling – manipulating CPT codes for maximum billing
  • Performing unnecessary medical procedures to generate bills
  • Forging doctor signatures or records
  • Paying kickbacks or bribes in exchange for referrals

5. Do you work in the pharmaceutical industry?If so, have you seen any of the following:

  • Promoting a drug for uses not approved by the FDA.
  • Payment of kickbacks or incentives to induce doctors to prescribe a drug.
  • Payment of kickbacks or incentives to induce favorable medical research for a drug.
  • Violation of manufacturing or testing procedures, resulting in sub-standard, weak or adulterated drugs.

6. If You Know About Fraud,

  • Which Government Agency is being defrauded?
  • Who is committing the fraud?
  • How does the fraud scheme work?
  • How long has it been going on?
  • How much money has been defrauded?
  • What evidence do you have to prove the fraud?

If you believe you have a valid qui tam whistleblower case, you should contact an attorney with knowledge and experience in handling these types of case.

Please Note: Rabin Kammerer Johnson provides these FAQ’s for informational purposes only, and you should not interpret this information as legal advice. If you want advice as to how the law might apply to the specific facts and circumstances of your case, please contact one of our attorneys.