Tips for Whistleblowers from The Healthcare Fraud Law Group

On How To Choose An FCA Attorney:

Under the False Claims Act (“FCA”), plaintiffs who sue on behalf of the United States (commonly referred to as relators, because their claims “relate” to those of the government) must be represented by an attorney. The choice of an attorney is key to the success of any case. Here are some questions you should ask before hiring an attorney to represent you in a False Claims Act case.

Does the attorney have in-depth experience with the False Claims Act?

It is of critical importance that the attorney you select have significant experience with cases under the FCA. The FCA has a number of complex procedural requirements, including the requirement that the case initially be filed and maintained under seal that must be strictly followed. Your case could be compromised if your attorney is inexperienced with these requirements.

Does the attorney understand the complex health care rules and regulations that apply to the Medicare and Medicaid programs?

Billing rules and regulations under the Medicare and Medicaid and other federal health care programs are very complex, and not every rule contained in the Medicare manual or in the fiscal intermediary’s guidance must complied with before the government will make payment. Be sure your attorney understands the Medicare and Medicaid statutes and regulations thoroughly before engaging him or her to represent you.

Does the attorney have the ability and judgment to advise you whether your case has a good chance of success on the merits?

Be sure that your attorney will give you honest advice about the strength of your case, and point out ways in which you can make a good case even better. The Healthcare Fraud Law Group believes in filing strong cases, and in helping our clients make their existing cases better.

Does the attorney have experience litigating FCA cases, and is he or she willing to consider doing so if the government declines to intervene in your case?

While some FCA cases settle reasonably quickly after the government intervenes, there are many meritorious cases in which the government declines to intervene. If that happens, does your attorney have experience litigating FCA cases in federal court, so that you will not be left without an attorney? Is he or she willing to take on the risks of litigating a declined qui tam case? If not, you should talk to a lawyer who has litigated those cases, so that you can receive an honest and thorough evaluation of the benefits and risks of going forward.

Does the attorney commit to represent you individually and vigorously, and to keep you informed of key developments in your case?

The key complaint from clients about their lawyers is lack of communication about the status and progress of the case. Make sure that your attorney is committed to keeping you involved and informed. Many questions arise while an FCA case is pending, and you should make sure that your calls and emails will be returned, and your questions will be answered.

On How And Whether To Report Fraud Internally:

There is no requirement under the False Claims Act that you must report fraud internally before you file suit. If you are considering reporting fraud internally, consult an attorney before you do so. Advance consultation with an attorney should help ensure that you report fraud in a way that brings your actions within the protection of the anti-retaliation provisions of the False Claims Act. If you report fraud in a way that affords you those protections, your employer cannot fire or demote you without incurring significant damages – double back pay, attorney’s fees and other compensa*tory damages.

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