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Elements of Good Qui Tam Lawsuits

qui tam lawsuit

qui tam lawsuitsIf you think you have discovered your employer has been committing fraud against the federal government, you may have a whistleblower case. Referred to as qui tam lawsuits, they are authorized under the False Claims Act.

This provides a viable way for ordinary citizens to bring an action against perpetrators of fraud against the government. The False Claims Act also provides the whistleblower protection from retaliation. If the government chooses to intervene, there is potential for a large reward for you if you are the relator, the term for the one who brings the legal action.

Not every situation that appears a company or person has committed fraud has the necessary elements to become a qui tam lawsuit. There are some important factors for you to consider in determining whether or not you have a case.

Acts That May Give Rise to Qui Tam Lawsuits

The False Claims Act defines types of violations that may give rise to qui tam lawsuits.

  • Knowingly presenting false or fraudulent claims for payment to the government.
  • Submitting a false record to the federal government in order to have a claim paid.
  • Knowingly being part of a conspiracy to ask the government to pay false claims.
  • Submitting a knowingly false statement or record to the government in order to avoid an obligation to transmit funds or property to it.

If you are aware of any of the activities, you may be on your way to filing a qui tam action. You still have some questions to answer for yourself before you pursue litigation.

Factors to Consider Before Filing your Qui Tam Action

A qui tam attorney will help you find your way through the false claims jungle. But, some questions you should answer before contacting legal counsel include:

  • Has there really been fraud? Do not confuse mismanagement, waste or a contractual dispute with fraud.
  • What evidence do you have to support your claim? This is a touchy area. You need to have more than just your word against the company that you claim is acting fraudulently. Do you have emails? Work logs? Any company records that are not proprietary? There is a fine line between documentation that you obtained legally and company records that are confidential and to which you do not have legal access.
  • Is this the type of action where you believe the government will intervene? Without government intervention, many cases are dismissed by courts on the theory that if the government will not intervene, the case may not have merit.

There are many other requirements and nuances involved in filing a qui tam lawsuit. An experienced qui tam lawyer will evaluate your information and help you know if you have a case. Contact us today. We would be happy to help you determine whether you’ve got a case.

Why Would I Need a Medicare Fraud Attorney?

Medicare Fraud Attorney

Medicare Fraud AttorneyIf you’re considering reporting Medicare fraud or have been the victim of retaliation for blowing the whistle, you may want to consider talking to a Medicare fraud attorney. Whistleblower laws are complex. In order to receive protection, you have to have reported an actual violation. The Medicare laws are complex. Without a strong background in Medicare law, even an experienced attorney may struggle to properly evaluate whether Medicare fraud occurred.

What Does a Medicare Fraud Attorney Do in a Whistleblower Case?

A Medicare fraud attorney’s job is to help you determine whether a Medicare violation occurred. If you are considering blowing the whistle, you may need help to prove that a violation occurred. The Medicare system is complex. Therefore, it is easy to feel that something is not quite right when a company is actually in full compliance with the law. Speak to a Medicare fraud attorney about the situation to find out whether an actual violation occurred. They can help you avoid a situation where you lose your job because of a mistaken fraud report. It’s important to know what whistleblower laws protect – and what they do not protect. Because of attorney-client confidentiality rules, you can almost always ask your own attorney for advice. That’s true even if you have a nondisclosure or confidentiality agreement with your employer.

Have you already made a report? Your employer will likely do everything they can to prove that no violation occurred. They will likely call on an experienced legal team who will work hard to find every possible defense and loophole. If they succeed, you may lose whistleblower protections. Working with your own experienced attorney can help. This way, you can ensure your claims are evaluated on their merits and not by your employer being able to outmaneuver you legally.

How a Medicare Fraud Claim is Evaluated

Medicare fraud typically involves some sort of false statement by a company. They may over-bill for services rendered or bill for services they never rendered. They may also engage in price-fixing. Finally, they may follow other non-competitive practices while claiming to operate under fair and open practices that give patients the best rates possible under market conditions.

When a fraud allegation is made, they will typically produce the falsified records as proof that everything was done properly. The key to proving a fraud claim is understanding how to exploit weaknesses in these documents. Furthermore, success depends on knowing how to use the available legal procedures to secure additional evidence that undermines the validity of these documents. This can be a monumental task for a layperson, especially if you are simultaneously fighting for your livelihood.

To schedule a consultation with an experienced Medicare fraud attorney, contact Bothwell Law Group today.

How Do I Find a Good False Claims Act Lawyer?

False Claims Act Lawyer

False Claims Act LawyerFederal False Claims Act claims are among the most complex legal claims. They stretch across multiple substantive areas of the law. They also have more procedural steps to take than a standard legal claim. All attorneys are technically qualified to work in every area of the law. However, the False Claims Act lawyer you choose can make or break your claim. There are a few things you may want to consider looking for in a False Claims Act lawyer.

Experience in a Specific Field

The False Claims Act covers many different types of fraud. This includes Medicare and Medicaid, disaster relief funds, defense contracting, and more. An attorney will need to be able to show that specific laws relevant to the industry were violated. Therefore, they will need to be familiar enough with the industry to know what evidence to look for and how to get it. An attorney with extensive experience in financial services industry may not know how to analyze medical billing records and build a strong Medicare fraud case.

Experience Working With the Government

All qui tam litigation under the False Claims Act must be reviewed by the Department of Justice. In many cases, the DOJ will take over the litigation. As a matter of legal procedure, all information that a whistleblower has must be turned over to the Government. However, it helps to ensure that the Government can pursue the case successfully. Hence, it can be helpful to have an attorney who knows how to present the potentially thousands of pages of documents in a way that highlights the most important information and makes the job of an overworked Government attorney easier.

Ability to Back Litigation

Lawsuits can easily have tens or hundreds of thousands of dollars in filing fees. There are also costs of obtaining and reproducing costs, travel expenses for witnesses, and deposition fees. Often, a large firm may be able to cover these fees pending a court order that the defendant reimburse them. However, a small firm may not have the financial resources to proceed. Additionally, a small firm attorney may not be able to provide enough attention to the case if they need to continue to take other cases to pay their daily bills.

A Track Record of Success

Past results are never a guaranteed of future success. However, they are one possible indicator that an attorney has the knowledge and experience to handle a similar claim. An attorney with a lengthy track record has already likely made and learned from the mistakes that a less experienced attorney might make that could damage or delay a case.

To speak with an experienced False Claims Act lawyer, contact the Bothwell Law Group today.

4 Facts Physicians Should Know about the Medicare False Claims Act

Medicare False Claims Act

Medicare False Claims ActAs a physician who files claims through Medicare, there is pertinent information you need to know about the Medicare False Claims act. The False Claims Act allows for the prosecution of individuals who commit fraud against the United States government. Most physicians believe they are not at risk for committing Medicare fraud. However, it is crucial to understand the act in order to protect yourself from liability.

Are you a physician who files claims to Medicare for services you provide? There are 4 facts you should know about the Medicare False Claims Act:

#1. It is always illegal to misrepresent a service or product supplied to a patient in a Medicare claim.

In some cases, physicians believe they are acting out of benevolence, falsely diagnosing patients to allow them access to further coverage under Medicare. Whether or not the intention was to commit fraudulent activity in order to obtain government funds, it is never acceptable to misrepresent a service or product supplied in a Medicare claim.

#2. You may be liable for your employees’ actions.

If someone in your billing department or another employer bills for a service or product that wasn’t provided or upcodes a service, you may be liable for their actions. This is because you are the person receiving the fraudulently obtained government funds. Also, it is your responsibility to supervise the employees you hire.

#3. Accepting gifts or kickbacks of any kind is prosecutable under the False Claims Act.

If a vendor of any kind offers you incentive for your using their product, or attempts to use kickbacks to bias you towards their product, this is consider to be illegal under the False Claims Act. Never accept gifts of any kind of pharmaceutical companies or medical supplies.

#4. It is illegal to retaliate against whistleblowers.

Have you been found liable for fraudulent activity committed in your workplace? Then you can be further prosecuted if you retaliate against the person who reported your fraudulent actions. Therefore, it is crucial that you treat all of your employees fairly. Never terminate or punish someone engaging in whistleblowing activity.

In order to create an ethical workplace, you can encourage in-house whistleblowing among your employees. Reward employees for practicing transparency and honesty in the workplace. If an issue of any kind arises, do not try to conceal it. Instead, quickly report any fraudulent activity by the employees working for you in order to protect yourself from liability. An experienced whistleblower attorney can you protect yourself and your patients against complaints like this.

Have questions about the Medicare False Claims Act? Call the Bothwell Law Group at 770.643.1606.

Pros and Cons of Whistleblowing in the Workplace

Whistleblowing in the Workplace

Whistleblowing in the WorkplaceBefore you choose to disclose your knowledge of fraud in your workplace, we want you to have a clear understanding of the implications of whistleblowing in the workplace. It is important for you to do the right thing. However, you should also be clear of the pros and cons of whistleblowing in the workplace before moving forward with a lawsuit.

In whistleblowing lawsuits, it is important to move quickly if you want to be the first to file. However, we don’t want you to move so quickly that you make a choice you regret. That’s why we suggest every potential whistleblower carefully consider the pros and cons of whistleblowing in the workplace:

Pro: Exposing Fraudulent Activity Is the Right Thing to Do

Perhaps the biggest advantage of becoming a whistleblower is being able to know you have made the right choice. After becoming aware of fraudulent activity occurring in your place of work, you can make the choice to expose the fraudulent activity so the government can recover the money lost.

Con: Your Career Could Suffer

Employers are prohibited from seeking revenge after an employee has exposed them for fraudulent activity. However, your career may still suffer because of your choice. Once your case becomes public, you may receive attention in the business world. Being labeled as a whistleblower could decrease your chances of being hired at a new company in the future.

Pro: Protection from Retaliation Is Available

Under the False Claims Act, all whistleblowers are protected from their employer’s retaliation. If you decide on whistleblowing in the workplace, you can be sure they will be angry. But you can also know you have legal protection if they decide to retaliate because of your choice.

Con: Your Relationships May Suffer

Even though you have chosen the right thing, your coworkers may not agree with your actions. Whistleblowers often stand alone. Friends they thought they could trust in their workplace will turn their back on them in order to protect their own reputation.

Pro: You May Get a Financial Reward

If a lawsuit stems from evidence of fraud you have provided, the government will seek to recover the funds they have lost as a result of fraudulent activity. If the lawsuit is successful, you could be rewarded up to 30 percent of the recovered funds.

Do you want to move forward with blowing the whistle on your employer? One of our skilled false claims act attorneys at Bothwell Law Group can help you take advantage of the rewards of whistleblowing. We can also help protect your from the disadvantages. Find out what you need to know about whistleblowing in the workplace by clicking this link or calling 770.643.1606.

Is There Really Any Protection For Federal Whistleblowers?

protection for federal whistleblowers

protection for federal whistleblowersWhistleblower laws were put into place to protect workers who report health and safety hazards, illegal activity, tax evasion, and certain other actions that go against the public interest. Both the government and general public have a strong interest in encouraging the reporting of these types of activities so that they can be remedied. Therefore, Congress has passed laws providing protection for federal whistleblowers from retaliation.

What Laws Provide Protection for Federal Whistleblowers?

The Whistleblower Protection Act of 1989 and Whistleblower Protection Enhancement Act of 2012 are the main foundation for protection for federal whistleblowers. If an employee reports activities covered under the act to a supervisor or appropriate government agency, they have protection. Termination is not an acceptable response. Neither is a reduction in pay or reassignment to a less desirable position. Your employer cannot reduce your hours or move you to a less desirable shift. Finally, they cannot suffer indirect retaliation such as hostility from management.

Whistleblower protections are also embedded into many federal laws. For example, OSHA provides protection for federal whistleblowers making safety complaints. Presidential Policy Directive 19 protects retaliation related to an employee’s security clearance. Further, securities laws provide protections for workers in the financial industry.

What to Do if an Employer Retaliates

Have you suffered adverse consequences after blowing the whistle? You will have to prove that your employer’s actions stemmed directly or indirectly from your actions as a whistleblower. Protection for Federal whistleblowers does not cover an employee if the adverse action stemmed from unrelated job performance issues or an employer’s operational needs. This gives employers a strong incentive to misrepresent the reasons for any action they took against a whistleblower.

After making a complaint, you should save any written communications with your employer. Also, document the date, time, and nature of any verbal communications. If the employer takes retaliatory action and you made a complaint to a government agency, they will usually have a process for opening an investigation into the retaliation.

You may wish to receive financial compensation for lost wages or other economic losses as a result of the retaliation. Hence, you may need to file a private lawsuit against the employer. You will need to prove that you engaged in protected whistleblower activity. Also, you will need to prove your employer’s discriminatory motive. However, your employer can also introduce their own evidence. It’s important to understand that even if you believe you are clearly entitled to compensation, this is a long and difficult process. Therefore it can be difficult to navigate what lies ahead without the assistance of an experienced attorney.

Have you been the victim of illegal retaliation? Do you want to learn more about the protections that may be available to you? Contact Bothwell Law Group to schedule a consultation.

How to File a Whistleblower Claim under IRS Whistleblower Protection Laws

IRS Whistleblower Protection Laws

IRS Whistleblower Protection LawsAlerting the internal revenue service (IRS) with information that you believe a person or business has violated the tax law is provided for under the IRS Whistleblower Protection Laws. The whistleblower has the potential of receiving a hefty reward if the information provided culminates in the IRS collecting the taxes and finds that the information provided “substantially contributed to the collection of tax.” The award is based on a percentage of the amount collected ranging from 15 to 30 percent.

How to file a claim under IRS whistleblower protection laws

There are certain criteria that the alleged IRS taxpayer violator must meet in order for the IRS to accept the whistleblower claim for investigation:

  • The total amount for collections, including unpaid taxes, interest and penalties must exceed $2 million.
  • Individual taxpayers who are reported must have gross earnings in excess of $200,000 for the taxable year that is under investigation.

If you believe the person or company you are reporting meet these criteria, your report must be filed on a specific IRS form and include:

  • As estimate of the amount of taxes you believe is owed.
  • A summary of all the facts upon which you base your claim.
  • An explanation of how you gained your knowledge of the alleged violation.

Your claim must be filed under penalty of perjury.  If the IRS decides to pursue the claim and determines you played any part in the company decision to underpay taxes, you will not receive any reward and may be criminally prosecuted for those actions.

Although the IRS pledges to protect the identity of the whistleblower as much as possible, you may be called to testify in a judicial hearing if  you are deemed to be “an essential witness.” If the IRS determines in cannot proceed without your testimony, it will notify you and give you the option of remaining anonymous and not pursuing the case, thereby giving up any claim to a reward.

After filing the claim, you  will not be privy to any information concerning IRS actions against the taxpayer or any specific information about the status of the case. You will only be told whether the case is open, denied, closed and payable and the amount of the award that you can expect to receive. It may take years for you to collect your reward since the reward is not paid until the entire amount of the taxes, interest and penalties in question have been collected.

The process is complicated and you need the assistance of attorneys who are dedicated to representing whistleblowers. At the Bothwell Law Group, we have the experience you need for filing your claim under the IRS whistleblower protection laws. We  work diligently to pursue your claim and protect your identity. Contact us today.

Game Changer for Whistleblowers

False Claims Act | SEC Whistleblower Claim

It looks like there has never been a better time to be a whistleblower. This is especially true for public companies or within the securities industry.

In 2010 the Securities & Exchange Commission’s (SEC) established a whistleblower awards program.  As a result, whistleblowers now have unprecedented financial incentives to disclose potential misconduct to the government.  Also, they are enjoying extraordinary legal protection for doing so.

Nowadays even compliance personnel, the employees tasked with identifying internal misconduct within a company, are receiving substantial payouts for reporting their own companies in some instances.

However, if you are the company being faced with a whistleblower, the situation has never been more difficult. The companies face several problems. One is the legal minefield when trying to deal with reports of misconduct. Another is the consequence of increased financial incentives for the whistleblowers to report actual or perceived misconduct. On top of it all, the companies are dealing with all this under an extremely tight reporting timeline.

Before Financial Incentives, Whistleblowers Were Scared To Speak Out

Before the awards program was established in 2010, whistleblowers had very little incentive to speak out.  Quite the opposite. They had incentive to stay quiet in order to avoid retaliation.

In 2002, the Sarbanes-Oxley Act of 2002 went into effect and whistleblowers were protected against retaliation. However, this provision was not only weak, it was often ineffective.

Paradigm Shift In 2010

The passage of the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010 changed everything for whistleblowers. This was the first time whistleblowers were offered a financial reward for whistleblowing relating to securities violations.

Million Dollar Settlements

Dodd-Frank directed the Commission to pay eligible individuals when the original information they provided lead to SEC and other enforcement actions to a monetary sanction over $1,000,000.  What does that mean for the whistleblower? With awards ranging from 10 to 30 percent of the total amount of money collected in a case, it means a lot!

Non-US Awards

The Commission determined that whistleblower awards need not be limited to those in the United States. Four of the 17 whistleblower awards to date were to whistleblowers living in foreign countries.

Penalties for Retaliation

Beyond the Sarbanes-Oxley Act of 2002, Dodd-Frank broadly prohibited retaliation against whistleblowers who report possible wrongdoing.

Thanks to the stringent protection and the financial incentives, 17 whistleblowers have received awards under Dodd-Frank, paying out nearly $50 million. The number of whistleblowers continues to rise.  The first quarter of 2015 saw a 20 percent increase in the number of whistleblower tips over the same quarter last year.

What companies subject to the SEC’s oversight should be concerned about:

  • The SEC has expressed intense interest in retaliation cases.
  • The SEC has recently granted awards to a company’s own compliance officers.
  • The SEC has voices a serious concern about the use of confidentiality agreements that may suppress SEC whistleblowers.


If you are a whistleblower or are considering being a whistleblower, contact a specialized whistleblower attorney as soon as possible.