Healthcare fraud comes in many forms, from someone stealing your identity to get prescription drugs to ordering unnecessary tests to drive up insurance billing. While some fraud may be easy to spot, others may not be as clear. Regardless of the type of fraud, you have the opportunity to speak out and report your suspicions. Whistleblower advocates, Fraud Expert Advisors, discusses how to report healthcare fraud.
- Gather evidence to support your claim. The evidence is a critical part of every investigation and will be necessary to prove your case. Begin gathering evidence as soon as possible to support the fraud allegations that you’ll be making. However, be mindful as you are gathering evidence because you don’t want to be exposed as a whistleblower early in the process.
- Discuss your findings with a non-attorney whistleblower advisor. Our FEA advisors have firsthand experience reporting healthcare fraud and will be able to guide you through every step of the process. They’ll help determine if there is a solid case or not and if you move forward, they will assist you in navigating the legalities of the process.
- Consider retaining an attorney. Attorneys will file a whistleblower lawsuit, also known as a qui tam claim, on your behalf. Whistleblower claims filed under the False Claims Act obtained more than $3.7 billion in settlements in recent years. The whistleblower in the case has the potential to gain a share of those settlements.
- Keep your findings and intentions between yourself, your attorney, and your FEA advisor. Discussing your case with anyone else is extremely risky. You may break your legal “seal” that comes along with a whistleblower case. Breaking that seal will prevent you from your potential reward if the case does settle. The best way to mitigate this risk is to only discuss your case with your attorney and FEA advisor.
Every year, fraud and abuse in the healthcare industry result in the loss of billions of dollars. If you’re aware of any healthcare fraud occurring in your current or former workplace, you can stand up for what’s right and have the potential to earn a financial reward for doing so. Whistleblower advocates, FEA, are always ready to assist and guide you through the whistleblowing process.