Types of Fraud:
Every year, billions of dollars in taxpayer money are improperly paid out as a result of fraud. The False Claims Act is a federal law that rewards whistleblowers for reporting fraud against government-funded programs. To be eligible for an award, the whistleblower, with the help of an attorney, files a lawsuit on behalf of the government describing the fraud. If the government is successful in recovering money from the lawsuit, the whistleblower is entitled to 15-30% of the government's recovery.
Healthcare fraud is the most common type of government fraud. Medicare, Medicaid, and TRICARE are all healthcare programs that are funded by the federal government. Common examples of fraud against government healthcare programs includes double billing, "up-coding," and billing for services that were not provided, were not necessary, or were provided by unlicensed providers.
Off-label marketing is another form of healthcare fraud. Pharmaceutical and medical device companies are prohibited from marketing their products to physicians for uses that have not been approved by the Food and Drug Administration (FDA). Improper marketing tactics by these companies have resulted in some of the largest False Claims Act recoveries in recent years.
Violations of the Stark Laws and Anti-Kickback Statute can also result in healthcare fraud. The Stark Laws prohibit a physician from making referrals for certain healthcare services to a provider that is owned by or provides compensation to the referring physician. The Anti-Kickback Statute prohibits the payment or receipt of any type of compensation in exchange for referrals for government funded health services.
In addition to healthcare fraud, other types of government fraud include:
- Fraud by Defense or Military Contractors
- Fraud against Department of Education Programs, including fraud by for-profit colleges
- Fraud against the Federal Mortgage Programs, such as the FHA Insurance Program or Fannie Mae/Freddie Mac
- Fraud involving any government contract or grant
Overbilling, submitting false reports, or failure to comply with regulations or the terms of a government contract are common types of misconduct that can result in a whistleblower claim under the False Claims Act.
In addition to the federal False Claims Act, many states and some cities also have whistleblower laws that allow a whistleblower to report fraud against government-funded programs and share in the recovery.
The Securities and Exchange Commission (SEC) Whistleblower Program allows an individual to report violations of the U.S. Securities laws and share in the government's recovery. Common violations include bribing foreign officials in violation of the Foreign Corrupt Practices Act, accounting fraud, investment scams, false or misleading statements to investors, providing unlicensed brokerage or advisory services, and insider trading.
The SEC Whistleblower Program allows an individual to report the violations anonymously if the whistleblower is represented by an attorney. A SEC whistleblower is eligible for an award of 15-30% of the government's recovery, but only if the recovery is greater than $1 million dollars.
The Internal Revenue Service (IRS) Whistleblower Program allows an individual to report tax fraud and receive 15-30% of any recovery by the IRS. To be eligible for an award, the unpaid tax liability must be greater than $2 million. Common examples of federal tax fraud include claiming improper deduction or exemptions, hiding or under reporting income, failure to withhold, and failure to pay estate taxes.
In addition to the IRS Whistleblower Program, New York State allows a whistleblower to file a New York False Claims Act lawsuit based on New York State tax fraud. Common examples of New York tax fraud include failure to pay individual or corporate income tax and failure to remit or collect New York sales tax.
The Commodity Futures Trading Commission's (CFTC) Whistleblower Program allows individuals to report violations of the Commodity Exchange Act and receive a reward worth 10 to 30% of the government's recovery. Like the SEC Whistleblower Program, a whistleblower is only eligible for an award if the government recovers $1 million or more; the whistleblower may also report the fraud anonymously with the help of an attorney. Common CFTC violations include investment scams, theft, and fraud involving commodities, futures or options trading, as well as improper marketing or false statements regarding commodities, options and other derivative investments.
Protection Against Retaliation
Many whistleblowers are employees of the entity that is committing fraud. Each of the whistleblower laws discussed above prohibit an employer from retaliating against the employee for investigating or reporting (internally or outside the company) misconduct that was reasonably believed to be a violation. Retaliation can take many forms-demotion, suspension, unwarranted disciplinary action, hostility and termination are all retaliation if motivated by the employee's legitimate whistleblower activities.
Our law firm handles whistleblower cases on nationwide-basis. All consultations are 100% confidential. And because we handle all our whistleblower cases on a contingency fee, we only receive a fee if the whistleblower receives an award or other recovery.
If you believe you have evidence of fraud against the government, tax fraud, SEC violations, commodities laws violations or have been subject to whistleblower retaliation, contact us anytime by dialing 1-866-734-6083, or by submitting an online inquiry through this website.
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