A whistleblower employee stands to gain $65,000 plus her attorney’s fees and costs for the qui tam action she filed against her employer was settled by the United States Attorney’s Office. This represents 20 percent of the recovery in her case. It might have been a larger recovery if she were in Minnesota, where whistleblowers can receive a larger percentage from this type of case.

The nurse practitioner in South Carolina alleged her employer committed health care fraud when he billed Medicare and other government health care programs as if the physician provided all the care to patients. In fact, most of the care was provided by mid-level providers such as the nurse practitioner or the physician’s assistant. Normally the fees for mid-level providers would only be 85 percent of the doctor’s fee.

Both Minnesota state and the federal False Claims Acts allow whistleblowers to file a lawsuit, also called a qui tam lawsuit, against persons or businesses that are committing fraud against the state or federal government. At some point after the lawsuit is filed, the government will intervene in the action and prosecute the rest of the case.

These laws refer to whistleblowers as “relators” and reward them with a share of the money recovered by the government: up to 25 percent under federal law and up to 30 percent under the Minnesota statute. Minnesota provides the higher percentage for relators if the government delays its intervention in the matter, forcing the whistleblower to continue to prosecute the case for a longer period of time.

It should be noted that not all employees win when they blow the whistle. In many cases the employer retaliates against the employee with a demotion, harassment, or even firing them. In those cases, there are state and federal laws that may allow the employee to seek compensation for lost wages, emotional distress, or punitive damages.

Source: CarolinaLive.com, “Health Care fraud claims settled in court,” Taylor Williams, July 13, 2012