Study Shows Massive Benefit to Government from Medicare Whistleblower Payouts

Actions brought by private whistleblowers, sometimes referred as qui tam litigation, have been valuable in the effort to fight fraud against the government. Under the False Claims Act, individuals who recognize instances of impropriety can bring a case on behalf of the government. Should the government collect any payment from the offending party through a verdict or settlement, the person who brought the case, known as the “relator,” receives an award, usually between 15 and 30 percent of the total recovery.

Various whistleblower programs exist at the federal and state levels. On the surface, they seem like a “win-win” proposition. Authorities that don’t have the resources to monitor every potential instance of misconduct can get reliable information about illegal activity. Meanwhile, diligent individuals not only have the chance to gain the satisfaction of knowing they saved taxpayer funds, but also can walk away with a substantial payment.  

Economist Jetson Leder-Luis wanted to go beyond the assumptions regarding whistleblower programs and analyze the data to see what type of return the federal government is getting on False Claims Act expenditures. Examining cases of Medicare fraud, Leder-Luis confirm that the whistleblower program provides an immense benefit, not just in direct recoveries but also as a deterrent to prospective wrongdoers. 

In 2018 alone, qui tam relators received approximately $300 million for their efforts in cases where the government obtained a total exceeding $2 billion. Moreover, Leder-Luis conducted four case studies involving an aggregate of $1.9 billion in government recoveries. He estimates an additional $18.9 billion in specific deterrence effects because improper spending was reduced in the same categories going forward.

The report notes how it is very difficult for patients, insurance companies and regulators to identify examples of healthcare benefit fraud. Often, only an employee or someone else with inside knowledge possesses the information needed to prevent illegal conduct and penalize violators. If you suspect that your employer or someone else is using misrepresentation to obtain government funds unlawfully, you have protection under the law and might be able to secure a substantial payout. 

Kardell Law Group has a long track record successfully representing whistleblowers in qui tam litigation. You can rely on us for honest, knowledgeable counsel about whether you might be entitled to a financial award.