Qui tam

government, otherwise known as a qui tam action. This qui tam plaintiff, referred to as a relator, is entitled to a bounty between 15% and 25% of the settlement amount in the situation where the government proceeds with the action brought by the relator. In the case where the government doesn’t proceed with the action, the relator is entitled to between 25% and 30% of the settlement amount. Traditionally there was a bar that limited a relator from bringing a qui tam action under the FCA and thus being

Officer of the state’s largest Obstetric Health Care Center, this author is responsible for complaints regarding fraudulent behavior in the center. The purpose of this report is to (1) evaluate how the Healthcare Qui tam affects health care organizations, (2) provide four examples of Qui Tam cases that exist in a variety of health care organizations, (3) devise a procedure for admission into a health care facility that upholds the law about the required number of Medicare and Medicaid referrals, (4)

Running head: HEALTHCARE FRAUD AND ABUSE Healthcare Fraud and Abuse Abstract Rising costs of healthcare is a valid concern for many households in America. A factor in the cost of healthcare insurance is fraud. Fraud is often very difficult to detect. The magnitude of healthcare fraud is unknown. Initial reimbursement and payment and billing timeframe of 90 days allows for fast payment of services, however, many times before there is an indication of fraudulent billing the company has closed

Being a Whistle Blower To some the word whistleblower just sounds like a bad thing to be called. So what is a whistle blower you may ask? A whistleblower is a person who informs on a person or an organization engaged in an illicit activity. So what are the pro to being a whistleblower, better yet what are the cons as well? Some of the pros are that the person who is a whistleblower is a courageous individual who recognize a wrong and are willing to take risks in order to see that the wrongs are

advantage of this behavior is that the Whistleblowers feel a deep satisfaction making a substantial contribution toward the welfare of society. Of course, personal gratification isn’t the only benefit of becoming a whistleblower. For example, in qui tam cases under the federal False Claims Act, Congress decided to give whistleblowers

* The False Claims Act During the civil war, the False Claims Act (FCA) was passed to prevent the fraud committed by companies that were selling supplies to the Union Army. The Act contained qui tam provisions which authorized citizens to speak out against those deceiving companies. The public awareness of the FCA has been growing since the passage of the 1986 amendments. The number of whistleblowers cases that were filed has grown significantly

Medicare Fraud: The History, Incidence, Costs and Institutional Remedies John H Everett Wayland Baptist Medicare Fraud: The History, Incidence, Costs and Institutional Remedies What is Medicare fraud? ("F&A," 2011, p. 1) states “Medicare fraud happens when Medicare is billed for services or supplies you never got. Medicare fraud costs Medicare a lot of money each year.” What is Medicare abuse? ("F&A," 2011, p. 1) defines this as “Abuse occurs when doctors or suppliers don’t

To many, the revealing of companies’ private information is an ethically reasonable action that deserves either less punishment than what it does today or no punishment at all. With some punishments for whistleblowing being ostracism, harassment, and demotion, people deem the amercements as unreasonable (Martin). These kinds of punishments are usually doled out to whistleblowers who work for large businesses, making their work environment more hostile and uncomfortable. Whistleblowers get themselves

The Life of a Whistle Blower Since the 1960s, the public value of whistle blowing has been increasingly recognized. Whistle blowing statutes protect from discharge or discrimination an employee who has initiated an investigation of an employer’s activities or who has otherwise cooperated with a regulatory agency in carrying out an inquiry or the enforcement of regulations. Many states have enacted whistle blower statutes, but these statutes vary widely in coverage. Some statutes apply only to public

History of Whistleblowing The definition of a whistleblower is a past or pesent employee or member of an organization, who reports misconduct to people or entities that have the power and presumed willingness to take corrective action, or to notify the general public of wrongdoing. In most cases, whistleblowers are employees of the ogranization but can be employees of government agencies as well. Normally the misconduct being reported is a violation of law, rule, regulation and/or a direct threat