False Claims Act Whistleblower Retaliation: A Team on Your Side

False Claims Act retaliation concerns belong in a conversation with our whistleblower experts about the fraud you questioned and what followed. A signed inspection with no equipment to perform it. Medicare therapy driven by a billing target instead of a patient’s needs. Those are the kinds of allegations insiders brought forward in the cases below.

What If I Am Fired?

Our whistleblower experts work with you and the False Claims Act whistleblower lawyers we bring in on both the suspected fraud and what happened at work. You can talk with us about the signoffs or bills you questioned and the company’s response.

Whatever your role, now or in the past, we work through your questions about becoming a whistleblower with you. Your position and an earlier internal report belong in that conversation.

Our work on reporting suspected fraud under the False Claims Act starts with understanding the business from your perspective. What work did the government pay for? What did you see being done? What concern did you raise? We want your account in your own words, including the details that make sense to someone who has done the job.

When the Inspection Record Contradicts the Work

An insider can explain the difference between a completed inspection and a signature saying it happened. The whistleblower’s complaint against United Airlines alleged that the company signed off on work requiring torque-wrench calibration testers while all those testers were away for calibration and recertification.

In the complaint’s account, the testers were away for calibration. The signoffs kept coming. We see a signature being asked to do the work of a test.

The complaint also alleged that a mechanic asked another mechanic to sign off with his stamp on repairs the first mechanic had both performed and inspected, making it appear that different people had done the work and checked it. In another passage, it described what happened when inspectors rejected a repair:

We see an inspection process turned upside down: a refusal becomes a search for a different signature.

The Fourth Circuit’s account of the internal report describes an email identifying the U.S. Air Force as the paying customer. That connection matters to our examination of the alleged fraud: the inspection standard, the work and the government customer belong in the same account. We would want to understand what you knew about each, rather than expect you to turn a technical objection into a finished case yourself.

When Billing Targets Override Clinical Judgment

Internal reports can also show a conflict between the care a patient needs and the care a business wants to bill. Life Care Centers of America agreed to a $145 million civil settlement in October 2016 over allegations involving medically unnecessary rehabilitation therapy. The government alleged that corporate policies targeted high Medicare rehabilitation reimbursement without clinical need and prolonged stays despite therapists’ recommendations for discharge.

The government’s complaint described employees complaining that the company encouraged them to maximize reimbursement even when that was clinically inappropriate. It also alleged that managers chose assessment dates to produce the highest payment and directed therapists in other disciplines to supply minutes another therapist considered unnecessary.

The complaint put that billing pattern in perspective: by 2008, Life Care billed nearly 68 percent of its Medicare rehabilitation days at the Ultra High level, against a nationwide average of 35 percent among skilled nursing facilities that year. That comparison gives the employees’ objections a business context beyond an argument about one patient.

For a health care insider, those are recognizable decisions: the assessment date, the recommended discharge and the manager’s instruction. In the government’s account, the billing target displaced the clinical judgment. We see the absurdity: the therapist says the patient has had enough, and management looks for more minutes.

United Airlines and Life Care involve different work, but the reports have something in common. They connect a specific operational concern to what the business represented or sought payment for. That is the kind of connection we examine with you, whether your work is in maintenance, healthcare, billing or compliance.

Why the Person Doing the Work Matters

The person inside the organization may hold information nobody outside it can supply. A Congressional Research Service report from 2009, Qui Tam: The False Claims Act and Related Federal Statutes, recounts Congress’s concern that an employee might be the only person able to bring information about company fraud forward.

The inspection and therapy allegations show what that knowledge can look like. The person in the shop can explain the missing tester or the inspector’s refusal. The clinician can explain the recommendation to stop treatment and the instruction to continue.

The paper’s point is concrete in both examples. Someone outside the business can read an approval or a therapy entry. The person who knows the equipment, the patient or the instruction can explain why that entry contradicts the work. That is the expertise we make central to the case.

Your Account Beside the Company’s Records

We build the account with you by connecting the work, the records and the decisions behind them. An internal report belongs beside the instruction, test or bill it questioned. The inspection examples turn on who performed the work and who approved it. The therapy allegations turn on who decided treatment should continue and why.

If you already hold a report, an email or records that prompted your concern, we discuss what they mean in the business you know. We also listen to what happened after you raised the issue. Our role throughout the False Claims Act case process is to bring that understanding together with the whistleblower legal team your case needs.

The Whistleblower’s Share of the Recovery

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers. The law provides for that share in a case brought on the government’s behalf.

Your Knowledge, Our Commitment

If you questioned an inspection signoff or a therapy bill, we help turn your knowledge of the work into your strongest whistleblower case. We stay with you through the process and bring in False Claims Act whistleblower lawyers who understand retaliation and your field. Speak with our whistleblower experts about the records you questioned and what happened after you spoke up.