Statistics indicate that nearly $100 billion in taxpayer money is lost every year in the U.S. due to Medicare and Medicaid fraud. That’s many hundreds of dollars coming out of every taxpayer’s pocket, all the while enriching dishonest criminals in the healthcare industry who profit off our financial loss. This is sadly not news for many of the honest people of integrity who work in the healthcare industry – ranging from nurses, doctors, accountants, processors, and even executives – who see this fraud occurring regularly and wonder what they can do about it. Such employees, professionals, and executives often find themselves caught between a rock and a hard place: do they report the wrongdoing internally and face repercussions, or do they go outside the organization to report to the authorities? Below are a few things to consider in making this challenging decision.

Your Internal Reporting Can Result in Retaliation Against You

Many companies offer internal reporting mechanisms for handling illegal conduct in the workplace, but, unfortunately, internal reporting is often not followed up on. Worse, companies will actually retaliate against employees for trying to internally report wrongdoing. Even as large and storied a company as Wells Fargo allegedly fired employees who tried to internally report on the bank’s widespread fraud.

As egregious as this sounds (and is), company authorities retaliating against employees for reporting misconduct is a predictable outcome. With the type of large-scale Medicare and Medicaid fraud that occurs where tens of millions of dollars are made in ill-gotten gains, the corruption can penetrate top management who have a strong interest in perpetuating the fraud and who may be willing to engage in illegal retaliation against employees who try to prevent it.

Another Person May Obtain a Whistleblowing Reward for Your Work

Those who provide the federal government with information regarding Medicare and Medicaid fraud which leads to the recovery of funds are entitled to a significant portion of the government’s recovery, generally between 15% and 25%. In 2016 alone, the federal government recovered $4.7 billion in False Claim Act actions (the law under which Medicare and Medicaid fraud claims are often pursued), and hundreds of millions of dollars have been paid in rewards to whistleblowers.

To obtain a reward, however, you should bring the government original information, meaning, if the government already has the information from another party, you may not be eligible for a reward. By reporting internally, you may give your valuable information of wrongdoing to another party who can in turn bring it to the government’s attention and seek his own reward based on your information.

Your Discussions With an Attorney Are Confidential

Many employees who are considering bringing a whistleblowing claim experience fear and trepidation about what might happen to them as a result of sharing information with others. But you should understand that when you speak with a whistleblowing attorney, even for an initial consultation, you are entering into a confidential relationship with that attorney. What this means is that your attorney cannot provide any information to others regarding what was said in your meetings without your consent. Thus, an attorney can provide guidance on whether to report internally or pursue a whistleblower claim (or do nothing) without risk of disclosure.

Work with Experienced Whistleblowing Attorneys You Can Trust

At Kreindler & Associates, we understand that the decision to become a whistleblower is not an easy one. The government relies on courageous insiders like you to come forward with information that can stop harmful Medicare fraud. Our experienced healthcare fraud attorneys will work with you every step of the way to determine your appropriate course of action, protect you from retaliation, and collect your much-deserved reward. If you suspect that someone is committing Medicare fraud, contact us today for an evaluation of your allegations.