Our Chicago medical malpractice attorneys have long been concerned about the healthcare fraud that runs rampant throughout the U.S. healthcare system – doctors, hospitals, and drug companies who abuse the trust of the U.S. public and take Medicare and Medicaid funds for their own personal gain. We are thus pleased to learn that new rules affecting whistleblower lawsuits give ordinary citizens additional powers to curb this offensive and illegal behavior.
In a nutshell, “whistleblower” actions are a mechanism created by federal law that permits ordinary citizens, whether related to the healthcare industry or not, to file a federal fraud action against a perpetrator of healthcare fraud, whether a pharmaceutical company, an insurer, a physician, or a hospital. In that way, the federal government is assisted in its efforts to reduce or eliminate fraud on the Medicaid and Medicare programs, and concerned citizens can themselves take action to prevent their tax dollars from unfairly lining the pockets of the perpetrators. The federal government then has the option of joining the action under the False Claims Act, a federal law dating back to the Civil War and geared towards preventing fraud against the United States.
From 1999 to 2009, the total amount recovered from whistleblower and related healthcare cases has increased dramatically. In fact, it has more than tripled. And this figure, which is drawn from data from the U.S. Justice Department, does not even include the largest whistleblower settlement of all time, which was announced in 2009 but was not effected before the end of the 2009 fiscal year. In that settlement, pharmaceutical giant Pfizer Inc. paid a staggering $1 billion in settlement money to end an investigation into off-label promotion (the promotion of a drug for a use for which it has not been granted FDA approval) related to the painkiller Bextra and three other drugs. Nor does this figure include the related criminal settlement, in which Pfizer paid another $1.3 billion .
Moreover, the sheer number of whistleblower healthcare actions has ballooned. Last year, a record number of these whistleblower actions were filed. Experts believe that this year’s numbers will easily break last year’s record – a prediction echoed by the medical malpractice attorneys of Passen Law Group.
That is because the laws governing such actions were amended in May of 2009. The overhauled version of the law adds new risks for healthcare companies in several different ways. First, the new law makes it easier for ordinary citizens and other whistleblowers to be be compensated or rewarded for uncovering healthcare fraud and reporting it. Citizen whistleblowers can now file actions when they learn about healthcare fraud, regardless of whether they were ones who actually uncovered the malfeasance.
The new version of the law also changes the substantive rules governing that fraud: for example, by shortening the amount of time that must elapse before action can be taken against medical providers who withhold overpayments from Medicare and Medicaid. There are literally pages of new rules with which medical providers must comply. Perhaps more importantly, the penalties for wrongdoing have also been sharpened. The fine for a single act of fraud, such as one falsified bill to Medicare, can now run as high as $11,000.
Because the whistleblower rules allow successful whistleblowers to be compensated for their courageous actions, there is now every incentive – both moral and financial – to report and take action to stop healthcare fraud if you learn of it. If you are aware of an instance of healthcare fraud, we urge you to take action. Talk to an attorney, and find out if your case is appropriate for a whistleblower action. All U.S. taxpayers – and perhaps your own pocketbook – will thank you.
For a free consultation with an experienced Chicago personal injury lawyer at Passen Law Group, call us at (312) 527-4500.