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when to report fraud

INDICATIONS AND PROPER ACTIONS OF REPORTING FRAUD

when to report fraud

When to report fraud is a question you may be facing if you are aware of it happening but aren’t directly involved. If you don’t report it, will you be in trouble? There are a lot of unknowns in the world of whistleblowing and fraud. It’s time to dig into it for some insight and to give you direction and peace of mind.

WHAT DO YOU MEAN REPORT FRAUD?

Fraud in this context refers to businesses that fraudulently take money from the US government in a variety of different ways, including Medicare fraud, criminal defense contract fraud, and nursing home fraud, to name just a few of the most common scenarios. There are many different ways people charge government programs for goods and services that are either not delivered or not justified.

Because fraud exists on such a broad level, laws have been created to encourage private citizens to report fraud when they witness it. These rules are known as False Claim Act laws, and they date back to the days of Abe Lincoln and the Civil War. Because people aren’t prone to report things that could cause them a backlash, the False Claims Act includes provisions for the whistleblower to receive a portion of any money recovered in a lawsuit. There are also laws to protect the whistleblower from losing their job.

Some of these laws and protections directly address just when and how we need to report fraud once we know about it. Surprisingly, there is not one simple, easy to understand rule. The law varies according to different industries, and it even changes from state to state.

The important thing to remember is if you are aware of fraud, you are likely obligated to report it, or else you may be found guilty of defrauding the government as well.

WHEN DO I NEED TO STEP FORWARD AND REPORT FRAUD?

Most people who report fraud are employees of the company committing the fraud. For example, one of the most common areas of fraud is within the program of Medicare. If you work in a doctor’s office as a nurse and never touch the bookwork, you probably have no idea the fraud is taking place. If you transfer to the accounting department, however, you may begin to see a problem.

Even if a person is involved in the actual fraudulent activities, they can still be the reporting whistleblower. The law does stipulate that fraudulent charges in Medicare cases need to be brought within 30 days of discovery of the practice. If a person is aware of the fraud and fails to report, they are in danger of prosecution under the law. However, even though the law allows for the prosecution, it rarely actually happens.

Even if a business or individual self-reports their participation in the fraud, they are not exempt from possible prosecution. Often, however, a judge will levy a lower penalty upon a voluntary disclosure of the activity.

HOW DO YOUR REPORT FRAUD TO THE GOVERNMENT?

Fraud is reported with a complaint made in District Court. The best practice for any whistleblower is to hire an attorney familiar with the False Claims Act. Choosing an attorney who works exclusively in this type of law is always the wisest decision.

Because there are so many ins and outs regarding the statutes of limitations, as well as different kinds of both penalties and protections for whistleblowers, it is critical to hire an attorney who understands all of the particulars of this area of law. The attorney will verify the facts in the case and prepare the complaint on behalf of the whistleblower.

Once the paperwork is brought to a district court, it is put under seal, prohibiting anyone, including the whistleblower, from breaking that seal by disclosing anything. The seal protects the identity of the whistleblower at this stage of the process. In fact, the defendant doesn’t even know an investigation exists. The original seal on the case is for six months. This timeframe is almost always extended, giving the government many months or even years to perform their investigations.

Once the inquiry is complete, the government makes a decision whether or not they will intervene, or take over, in the case. If the federal government does decide to step in, they take over the prosecution of the case. The court serves the defendant notice, and quite often a settlement is reached without actually going to court

IF YOU ARE AWARE OF FRAUD, REPORT IT TO A WHISTLEBLOWER ATTORNEY

If you are aware of fraudulent billing practices taking place at your place of work, or any organization for that matter, contact an attorney who works in False Claims Act law right away. Even if you are knowingly participating in the illegal activity, you should retain an attorney and file the complaint.

If you are not actively involved and the court determines proof of fraud, you are entitled to between 15% and 25% of the monies recovered. The amount of that reward can reach millions of dollars in some cases. Have questions about when to report fraud? Contact the Bothwell Law Group online now.

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