Did you know that whistleblowers have national days of recognition devoted to them? Seventeen of such days exist, among them National Report Medicare Advantage Fraud Day on April 24, National Report Government Contractor Fraud Day on May 8, and National Report Kickback Fraud Day on September 18.
For the first time on January 23, 2017, a new national day of recognition was celebrated: National Report Pharmaceutical Fraud Day.
Why a New National Day for Whistleblowers?
It was decided that a new national day was needed because pharmaceutical drug fraud makes up a large portion of Medicare and Medicaid fraud, and Medicare/Medicaid fraud is the most common type of fraud brought to light under the False Claims Act (FCA).
It’s estimated that 10 percent of Medicare funding is lost to fraud and false claims. In fiscal year 2017, Medicare funding was set at nearly $600 billion, meaning that $60 billion was lost to fraud.
What Types of Pharmaceutical Fraud Exist?
To report fraud, you have to be able to recognize it when you run across it. Five types of pharmaceutical industry fraud schemes are common:
- Kickbacks (a reward, in money or gifts, for prescribing or promoting a certain drug)
- Best price violations (selling drugs to Medicaid at a price that is higher than the lowest one charged)
- Overcharges in the 340B drug pricing program (violating the pricing program that provides drugs at a significant discount to underserved communities)
- Off-label marketing (promoting a drug for a condition not approved by the FDA in order to gain Medicare/Medicaid sales)
- Manufactured compounded drugs fraud (pharmacists who create compounded drugs by mixing custom medications who charge more for the compounds than an equivalent commercially-available drug).
Rewards for Healthcare Whistleblowers
Those who successfully bring a case under the FCA because they have actionable information can expect to receive an award of 15 to 30 percent of the funds recovered by the Department of Justice. When it comes to reporting healthcare fraud, the rewards can be substantial:
- Healthcare fraud case recoveries initiated by whistleblowers have added up to over $30 billion dollars to date.
- Almost $5 billion of that amount has gone to the whistleblowers.
- Approximately 83 percent of all government healthcare fraud cases have begun with a whistleblower.
- The biggest whistleblower award for reporting healthcare fraud was $150 million.
- The average whistleblower award in healthcare fraud cases is $688,826.
Suppose I Want to Celebrate the Day?
The best way to observe National Report Pharmaceutical Fraud Day, or any whistleblower fraud day, is to report fraud you have personal knowledge of, as long as you are prepared to become a whistleblower.
If you do not have any personal knowledge of fraud but you work in industries that can experience violations of the FCA (any health care industry involved with Medicare, Medicaid, or TRICARE; military and defense government contractors; procurement; or the securities industries), you could spend time educating yourself about the types of false claims frauds that could occur in your field of work.
Who Created National Report Pharmaceutical Fraud Day?
An attorney who spent more than 15 years in the Department of Justice’s whistleblower reward office came up with the idea. While at the DOJ, Joel Hesch recovered over $1 billion from those alleged to have committed violations of the False Claims Act specific to Medicare. He also ensured that whistleblowers were awarded hundreds of millions of dollars.
Making a difference.
If you think you have the facts needed to bring a whistleblower case, the experienced whistleblower attorneys at the Louthian Law Firm can review your case and help you file the appropriate disclosure statement. Under some circumstances, the government will intervene, or join in your lawsuit.
Your chances of succeeding are greater if your whistleblower claim is substantive, clear, and to the point. Because of this, meeting with a qualified whistleblower attorney can increase your chances of winning. The Louthian Law Firm can help you form your claim so that the government will be more inclined to intervene in your case; government intervention can sometimes increase the chances of recovering reward money. Even if the government decides not to intervene, it could still be a good idea to pursue your case without government involvement. Our strong support system can assist you through every step of the process.
For a free, confidential evaluation of your case, call the Louthian Law Firm today at 1-803-454-1200 or, if you prefer, you can fill out our online contact form.