Health care fraud is on the rise and an investigation by USA Today reports that prosecutors are taking more aggressive actions to put an end to the practice. In many cases this was only possible because employees and private citizens “blew the whistle” on the fraud. In 2010 there was a 24 percent increase in prosecutions against those abusing government programs. During this same year government officials recovered four billion dollars from health fraud cases.
Employees and private citizens play a crucial role in uncovering fraud and stopping these abuses by bringing cases to the government that are often referred to as qui tam suits. These cases allege violations of the federal False Claims Act and many similar state laws.
The government encourages the use of qui tam suits by compensating those who come forward with evidence of fraud (called “relators”) a percentage of the award granted by the court. In 2010 over $300 million dollars was paid to these whistleblowers for helping to put an end to fraudulent practices.
How Qui Tam Suits Work
The origin of qui tam suits under the False Claims Act goes back to the Civil War. Congress responded to the sales of decrepit mules and defective equipment to the Union Army by passing the False Claims Act in 1863 to encourage private citizens to come forward when they had evidence of fraud. The law was revitalized in the 1980s, when Congress recognized that it was losing a fight against “rampant fraud” involving federally funded contracts and programs.
Initially, a number of qui tam suits were filed involving Department of Defense contracts but in recent years filings have shifted to focus on fraudulent acts involving Medicare and other health care programs used by hospitals and nursing homes.
A qui tam lawsuit can attack a wide array of abuses, such as:
- Billing for goods or services never delivered
- Performing inappropriate or unnecessary medical procedures to receive Medicare payment
- Selling products with known defects to the government
- Achieving sales or winning a contract through use of bribes or kickbacks
Qui tam suits can be filed for fraud against state or federal government agencies. In Minnesota and under the federal False Claims Act, suits can result in a relator receiving between 15 to 30 percent of the recovery or settlement.
If you or a loved one is aware of fraud occurring against the government contact an experienced Minnesota qui tam attorney to discuss your legal options.