Healthcare Fraud and Qui Tam Lawsuits

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Healthcare Fraud in Newberry Can Lead to a Qui Tam Lawsuit

Qui Tam AttorneyHealthcare fraud can include fraudulent actions against insurance companies, drug or prescription fraud, or government fraud. When healthcare fraud involves government programs like Medicaid or Medicare, the False Claims Act can help witnesses file a qui tam lawsuit against the company misusing or stealing federal dollars.

Qui tam lawsuits rely on one or more whistleblowers, who have witnessed fraud against the federal government, to file an action claiming that the business misused federal money or stole money from the government. In 15-25% of whistleblower filings, the federal government will join the qui tam lawsuit and pursue legal action to recover the money lost.

In the case of Medicaid and Medicare fraud, a company will often file fraudulent healthcare statements for services not actually provided, or overbilling for services, in order to receive more money from the federal government. Sometimes, this money is even funneled into kickbacks to other healthcare providers for patient referrals. These actions are illegal and if you have witnessed this type of fraud in your workplace, you may have grounds for a qui tam lawsuit.

Healthcare Qui Tams in South Carolina

South Carolina has many poor, rural residents, which means that many healthcare agencies rely on federal and state spending to provide healthcare services for those in need. However, too many businesses have developed practices to exploit federal money by lying about home visits or services for home-bound populations; over-estimating hours spent with patients; or overbilling for prescription medications. Not only does the federal government lose money, but needy populations do not actually receive necessary healthcare services, which can put their lives in jeopardy.

If you work for a hospital, insurance company, pharmacist, nursing home, or other healthcare provider and you believe you have witnessed Medicare or Medicaid fraud, a qui tam attorney can assist you in evaluating your potential case.

I Suspect My Employer of Fraud and I Want to Understand Qui Tam Litigation

If you have witnessed suspicious business practices in your workplace, which have defrauded the federal or state government of money, you may have a qui tam lawsuit.

Fraudulent Practices & Qui Tam Lawsuits

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Fraudulent Business Practices in Columbia Lead to Qui Tam Lawsuits

Whistleblower AttorneyQui tam (pronounced “key tam”) is Latin for “who as well.” These lawsuits, brought forward by one plaintiff called a whistleblower, request that the federal government join as well, and potentially other whistleblowers, who have witnessed corruption within a specific business that violates a law or government contract.

Common whistleblower lawsuits involve antitrust violations, in which a business tries to become a monopoly; Medicaid and Medicare fraud lawsuits, in which a healthcare company lies about the cost of healthcare, or the type of healthcare provided, in order to receive federal money; and contractor fraud, which includes environmental and defense contractors, and involves the contractor lying about services provided, providing faulty equipment, failure to comply with local laws, or using kickbacks to receive favors.

Before Filing a Qui Tam Lawsuit in South Carolina

If you work for a government agency, work for a business that contracts with a government agency, or work for a business that receives state or federal money, you may have witnessed bad business practices or fraud, and you may not know what to do. Too many employees keep quiet in order to keep their jobs, especially in the wake of the recent Recession.

If you do choose to pursue action, and confront your employer, you are within your legal rights to do so. However, sometimes employers react poorly when they learn that employees have seen fraudulent business practices and will fire the employee that reports it. This is retaliation, and can be added to the indictment you file in your qui tam lawsuit. It is illegal for businesses to retaliate against employees who blow the whistle, whether the employee files a qui tam lawsuit or simply reports the fraud to a superior.

I Might Have Witnessed Fraud in the Work Place, Should I File a Qui Tam Lawsuit?

You may have experienced fraudulent business practices at your workplace, and believe you should file a qui tam lawsuit. This type of litigation takes years, in many cases, and is extremely complex. Do not go into complex litigation alone; contact a qui tam attorney for help.

Whistleblower Actions Can Lead to Qui Tam Cases

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Whistleblower Actions Can Lead to Qui Tam Lawsuits in Augusta

Qui Tam AttorneyA qui tam action is a type of litigation that one or more whistleblowers, who are the primary plaintiffs, bring forward to alert the federal or state government to fraudulent business practices that abuse laws or mishandle federal dollars. The term “qui tam” comes from a longer Latin phrase qui tam pro domino rege quam pro se ipso in hac parte sequitur, which means “he who sues in this matter for the king as well as himself.” Whistleblowers who file qui tam lawsuits hope that the federal government will join the suit as a plaintiff.

The False Claims Act is the American law that allows whistleblowers to bring fraudulent business practices to the federal government’s attention. The law was bolstered with additional protections for whistleblowers in 1986, but a whistleblower must still meet certain criteria in order for the qui tam lawsuit to be accepted by the federal government.

Specific Whistleblower Requirements for South Carolina Qui Tam Lawsuits

In order to legitimately file a qui tam lawsuit, a whistleblower must meet the following criteria:

  1. The whistleblower must have first-hand knowledge of the fraud, and have evidence to support it. Whistleblowers cannot rely on hearsay about fraudulent actions against the federal government from coworkers; the whistleblower must have seen the fraud first-hand, and have evidence providing the “who, what, when, and where” to present at the trial.
  2. Publically disclosed information regarding fraudulent business practices is insufficient. Just because you see or hear information through a news broadcast, or news write-up, does not mean you can use that as evidence for qui tam litigation. You must bring additional information in order to file a qui tam lawsuit.
  3. Federal or state money must be involved. This means that the fraud must involve misused money with government contractors, healthcare fraud, or another type of fraud in which the federal government loses money, except –
  4. The fraudulent business practices may not be tax fraud. There are separate laws that govern tax fraud lawsuits, so the fraudulent practices against the government may not be tax fraud in a qui tam lawsuit.

My Employer Has Committed Fraud Against the Government and I Want to File A Qui Tam Lawsuit

Although you can file a whistleblower or qui tam lawsuit yourself, this is a complex type of litigation and you could wait years before the federal government joins your action. Get help with this complicated lawsuit. If you live in South Carolina or Georgia, the attorneys at the Strom Law Firm can offer a free consultation to discuss the facts of your qui tam lawsuit.