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Whistleblowers are Critical in Preventing, Limiting Medicare Fraud

During a recent interview with the AARP, U.S. Attorney General Jeff Sessions said Medicare fraud must be taken as seriously as the war on drugs in this country. That’s saying something, considering the hardline stance Sessions has taken on the enforcement of drug laws. However, it’s not difficult to see why he’s so passionate about it, as approximately 10 percent of Medicare funds are lost every year to fraud and general waste. That adds up to about $16.2 billion annually.

Whistleblowers play a crucial role in the limitation of Medicare fraud. Their close proximity to the wrongdoing makes them uniquely situated to discover fraudulent and predatory practices, and to report those practices when possible. Without the assistance of internal whistleblowers, the governing agencies responsible for cracking down on Medicare fraud would rarely get the evidence they need to take enforcement action.

Using the False Claims Act

The False Claims Act (FCA) is one of the most commonly used laws by whistleblowers who uncover instances of fraud in their workplace. Under the FCA, whistleblowers can file lawsuits on behalf of the federal government. If their case leads to successful enforcement actions, the whistleblowers may collect between 15 and 30 percent of funds collected in a verdict or settlement.

The growing number of FCA cases over the past several years has played a significant role in the more widespread discovery of Medicare fraud. Officials strongly believe that if the awards for whistleblowers were increased, the FCA would become even more powerful and more whistleblowers would come forward. About 92 percent of all money the government collected under the FCA last year came from cases initially started by whistleblowers.

The U.S. Department of Justice has floated around ideas that would limit the number of FCA cases, even though they are crucial for limiting fraud and abuse.

For further guidance on how you can file a claim under the False Claims Act, meet with an experienced Dallas attorney at Kardell Law Group.

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  • "Steve Kardell was terrific in representing me in some very adversarial discussions with Citigroup and also later represented me in my testimony before the Financial Crisis Inquiry Commission."  -Richard Bowen, Citigroup Whistleblower

  • "Never thought my career would end like it did after 30 years of service. I was part of the first round of the so called reduction of force. I asked myself how can I be part of this with 30 years of seniority. How did they pick these 90 plus employees? Now, the culture of this organization made you question every decision they made. It wasn’t what you knew it’s was a culture of who you know. Nonetheless, I did not accept their severance package. I immediately starting looking for an attorney who would take on my case. After the initial call to Steve I had hope again. He was open and honest about everything and reassured me he would do his best for me, and he did. I had an awesome outcome. Thanks Steve you’re the best."  -S.S.

  • "Reaching out to Steve Kardell was the best decision I made. His ability to provide immediate insight and direction was very powerful, and a huge relief during a very stressful time period. For anyone struggling with a whistleblower situation, I would highly recommend at least speaking with Steve. After a 10 minute call with him, I had a better understanding of what I was dealing with. Even better, he gave me some immediate hope. In the end Steve did a better job than I thought was possible. Steve was able to get in contact with people in my organization, that I didn’t have access to. Because of his years of experience, he already has contacts in many organizations in Dallas. The entire situation was handled peacefully. I was impressed by his ability to “keep the peace”–rather than creating a battle with the organization. The reason I didn’t reach out to a lawyer initially, was because I thought it would mean an immediate end to any hope of a positive relationship with the company. Steve was able to address my concerns, and in the end I was able to continue to work for them."  -KS

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