Whistleblowers play a crucial role in alerting law enforcement to fraud and to assisting in bringing the perpetrators to justice. Based upon the information of whistleblowers, the U.S. government has been able to recoup considerable money paid in fraudulent schemes. Yet, whistleblowers bear a substantial risk for coming forward. Fortunately, the laws protect whistleblowers from retaliation for doing the right thing and, in some cases, allow the whistleblower to stake a claim to a portion of the money recouped by the state or U.S. government agencies.
Schneider Wallace advocates for the rights of whistleblowers who report healthcare fraud, kickbacks, Medicare fraud, pharmaceutical fraud and procurement fraud and ensures that whistleblowers are treated fairly and protected from retaliation. Our qui tam and whistleblower lawyers take decisive, assertive action to further ensure that a whistleblower is aptly rewarded in return for reporting the fraud and maximizing the awards available under federal and state False Claims Acts, IRS tax whistleblower program, and SEC whistleblower program.
What Are Whistleblower Rights?
Whistleblowers rights are governed by several state and federal laws, but generally include:
- Freedom from retaliation for reporting unlawful activity or for cooperating with an investigation
- Damages resulting from an employer’s retaliatory conduct, such as termination, loss of a promotion or harassment
- A portion of the government’s monetary recovery that relied upon the whistleblower’s information
- Other remedies specific to a particular whistleblower claim
The government awards contracts to vendors based upon a procurement process. Typically, the lowest bid or one that satisfies specific criteria wins the contract for purchases of goods or services. Procurement fraud occurs when bid rigging results in a contract being unfairly awarded, often in exchange for cash or in-kind payout.
The Occupational Safety and Health Administration (OSHA) maintains a whistleblower program for reporting workplace safety violations and preventing retaliation against employees who report violations. The U.S. Department of Labor reported that OSHA whistleblower claims rose 30% in 2020 due to Covid-19 workplace safety violations. Over 4,000 Covid-19 complaints have been filed as of December 15, 2020.
In addition to OSHA whistleblower reports, thousands of individual employee lawsuits related to Covid-19 have been filed around the country.
False Claims Act (Qui Tam) Lawsuits
The federal False Claims Act was the nation’s first whistleblower law intended to combat fraud against the United States government. Most states have passed their own False Claims Acts to protect against fraud on state and local governments. The False Claims Acts award large financial rewards to individuals who report misconduct or fraud upon the government.
Any misconduct or fraudulent action that costs the government money – whether it be overcharging for a good, charging for goods or services not delivered, substituting in an inferior good than what was contracted for, or avoiding a payment to the government – is covered by the False Claims Act. Whistleblowers can bring qui tam lawsuits against those who have defrauded the government and prosecute False Claims Act claims on behalf of the government. Schneider Wallace represents whistleblowers and ensures they receive the full protections and monetary awards available under the False Claims Act and whistleblower programs.
IRS Tax Whistleblower
The Tax Relief and Health Care Act of 2006 established the modern IRS tax fraud whistleblower program and its reward structure. Every year, the IRS receives more than 10,000 new claims of IRS tax fraud, tax evasion, or tax underpayment.
Individuals are subject to fines of $250,000 for tax evasion, while corporations can receive fines up to $500,000. In addition to fines, a guilty party must make tax restitution. Tax restitution is the repayment of taxes owed to state and/or federal governments. This is in addition to penalties or fines.
Since 2007, the IRS has awarded nearly $1 billion to whistleblowers for their efforts in assisting tax collection.
The SEC Whistleblower Reward Program provides monetary awards to individuals who report fraud and misconduct involving security law violations within the United States. Individuals who report wrongdoing can choose to remain anonymous. Neither the SEC nor the whistleblower’s attorney will reveal the whistleblower’s identity.
Awards are given after a tip leads to a successful enforcement action against a defendant. If the SEC determines that the whistleblower provided new information or significant assistance, the SEC can award 10% to 30% of the sanctions to the whistleblower. In 2019, the SEC Investor Protection Fund distributed $142 million to whistleblowers.
Healthcare fraud costs millions of dollars each year to insurance companies and to the Medicare and Medicaid Services (CMS) program. Potential fraud includes kickbacks, upcoding, unbundling, billing for unnecessary services or products, billsing for items that were not provided to the patient, billing unseen or nonexistent patients and stealing the identity of another patient.
Kickback schemes typically involve referring a patient, prescribing a drug or selling certain medical equipment in exchange for cash or in-kind payments. Kickbacks drain money from the Medicaid and Medicare programs as well as interfere with doctor-patient relationship.
Medicare fraud involves billing the CMS for services or products that are unnecessary, not provided to the patient or at a higher price. A whistleblower who reports Medicare fraud and assists with the investigation may be entitled to a percentage of damages under the False Claims Act.
The pharmaceutical industry has been a repeat player in schemes to defraud the government. Common schemes include off-label marketing for purposes not approved by the FDA, violations of good manufacturing practices that rise to the level of fraud, manufacturing of compound drugs that are commercially available, exchanging kickbacks for prescribing certain medications and running pill mills to sell in-demand pharmaceuticals on the black market.
Learn More About Whistleblower Rights and Recovery
Learn more about whistleblower claims. Consult with a Schneider Wallace employment lawyer at our California, Texas or Puerto Rico offices. Our lawyers regularly appear before state and federal administrative agencies and courts to litigate issues concerning whistleblowers.