Nursing Home Whistleblower Lawsuit
If you work in a nursing home, you might be aware of some illegal practices occurring in the healthcare facility. Overbilling, filing false claims, and submitting fraudulent Medicare or Medicaid charges are serious offenses committed by nursing homes. Usually, employees are the only ones aware of this kind of nursing home fraud. An experienced whistleblower lawyer will be able to address your concerns and explain your legal options.
Quick Links
- What is a whistleblower?
- What is a qui tam lawsuit?
- What is the False Claims Act?
- Verdicts and Settlements
- How do nursing homes commit fraud?
- Reporting Medicare and Medicaid Fraud
- Nursing Home Abuse
- Reporting Nursing Home Abuse
- Whistleblower Lawsuits in California
- California Whistleblower Lawsuit Attorney
As a nursing home employee, you might have noticed questionable protocols like charging Medicare for services that were never performed. Although nursing home employers might insist practices like overbilling or double-billing programs like Medicare and Medicaid are commonplace or harmless, these acts are major crimes.
If you have witnessed any kind of fraudulent activity or nursing home abuse committed or encouraged by your employer, you might be able to file a whistleblower lawsuit. Healthcare facilities should be held accountable for breaking the law through fraud or nursing home abuse.
What is a whistleblower?
A whistleblower reports abuse, fraud, or any kind of corruption. Usually, a whistleblower is an employee who discloses information related to an employer’s illegal or unsafe actions. Whistleblowers voluntarily divulge details to relevant government agencies like the IRS or NHS.
In some cases, whistleblowers can be eligible for compensation. The money a whistleblower is entitled to is based on the amount of money a government agency can take back from a business that has been committing fraud.
Whistleblowers don’t have to be employees. It is common for employees to be whistleblowers because they usually have more familiarity with how a company operates and can easily document fraudulent activity. However, non-employees can also be whistleblowers, including:
- Customers
- Clients
- Consultants
- Other businesses
- Former employees
You can file a whistleblower lawsuit as long as you have specific, not speculative, insight into corrupt practices.
What is a qui tam lawsuit?
A qui tam lawsuit is a type of whistleblower lawsuit, and it is filed by an individual on behalf of the government. In a qui tam lawsuit, the whistleblower is known as a relator. Even though the relator is the party initiating the lawsuit, the government is actually the plaintiff.
What is the False Claims Act?
The False Claims Act has been around since the late 1800s as a reaction to contractor fraud during the Civil War. Under the False Claims Act, the government can receive compensation and extra damages from anyone who intentionally submits false claims.
Because of the False Claims Act, the government can directly seek compensation for fraud. Additionally, a whistleblower can also file a qui tam lawsuit on behalf of the government and earn up a percentage of the monetary award recovered in the suit.
The False Claims Act falls under federal law, but many states also have their own version.
Verdicts and Settlements
At Cutter Law P.C., we have a long record of successfully representing whistleblowers in multiple industries. Below is a representative snapshot of the successful cases our law firm has handled:
$23.5 Million
Settlement won for government fraud in a whistleblower case against one of the world’s largest medical device manufacturers
$240 Million​
Settlement in a nationwide defective medical device case involving defective pacemakers and cardiac defibrillators against Boston Scientific and Guidant
$12.95 Million
John R. Parker recently handled a case against the medical device company, Biotronik, Inc. for claims that they defrauded state and federal government agencies.
$4.7 Million
Brooks Cutter and John Parker obtained the settlement on behalf of our whistleblower clients in a case involving government fraud.
How do nursing homes commit fraud?
Overbilling Medicare and Medicaid is one of the most common types of nursing home fraud. Many nursing homes have a profit-first mentality. This can cause some nursing homes to prioritize money over properly caring for their patients and often leads to fraudulent practices becoming commonplace.
For example, nursing homes have been caught submitting false claims to Medicare for services they never actually provide patients. If the medical service being billed to Medicare is a regular practice at nursing homes, it can be difficult for the government to know the claim isn’t legitimate.
Reporting Medicare and Medicaid Fraud
Although Medicare and Medicaid have systems in place to monitor for fraudulent billing, it can be challenging to catch every instance of fraud committed by a nursing home or healthcare facility. Nursing home employees will usually be aware of Medicare and Medicaid fraud before the government agencies ever pick up on it.
In nursing homes, instances of Medicare and Medicaid fraud might include:
- Billing for healthcare services that were never performed
- Manipulating the coding for services rendered to receive more money
- Submitting multiple claims for the same service
- Filing claims under a deceased patient’s ID
If your nursing home engages in these illegal practices or presents false claims to Medicare or Medicaid, you can file a whistleblower lawsuit. You can also report fraudulent claims to the Centers for Medicare and Medicaid Services.
Nursing Home Abuse
Aside from fraud, nursing homes and other healthcare facilities might also abuse patients. If you have seen nursing home abuse, you don’t have to remain silent.
Nursing home patients deserve to be treated with the utmost respect. Unfortunately, many nursing homes fail to provide compassionate care for their patients.
As a nursing home employee, witnessing vulnerable patients being mistreated in any way can be disturbing. Even more upsetting is if the nursing home abuse is a systemic problem at your medical facility.
Abuse cases can be gut-wrenching. There have been reported incidents of nursing home employees doing rounds and regularly finding patients covered in bedsores or unconscious on the floor.Â
This level of neglect should be reported to the California Department of Health. Nursing homes shouldn’t be allowed to operate if patients are abused.
Even if nursing home abuse isn’t intentional, the understaffing of nursing homes can result in patients being mistreated and abandoned when they need healthcare.Â
Nursing homes and other care facilities must ensure the safety of their patients. The standard of care offered by healthcare providers in nursing homes should never leave a patient in distress.
Reporting Nursing Home Abuse
Because nursing home employees spend more time in the facility than a patient’s friends or family, they are most qualified to report abuse and neglect cases. However, it can be terrifying to speak out against your employer. You might worry about getting fired.
A whistleblower lawyer who files nursing home abuse lawsuits will be able to help you navigate your rights as a whistleblower while fighting for the protection of nursing home patients. If your employer retaliates against you for whistleblowing, an attorney can also help you file a retaliation lawsuit.
Don’t let fear of losing your job keep you from standing up for what is right. If you have seen incidents of nursing home abuse, you have a right to speak up for the neglected patients who can’t protect themselves. A whistleblower lawyer will be able to aid you in the process and file appropriate legal actions if you face any retaliation.
Whistleblower Lawsuits in California
If you have witnessed acts of Medicare or Medicaid fraud or abuse at your nursing home, you might be able to file a whistleblower lawsuit. Even if the government decides not to be involved with a lawsuit, a whistleblower can still move forward with legal proceedings.
In California, whistleblower lawsuits are governed under the California False Claims Act. The act allows the California Attorney General to investigate and prosecute fraudulent activity. There is also a qui tam provision to the act that allows a whistleblower to file a lawsuit on behalf of the state and receive a percentage of the government’s compensation.
According to the California Attorney General, hundreds of millions of dollars have been recovered thanks to whistleblower lawsuits associated with the California False Claims Act.
Testimonials
California Whistleblower Lawsuit Attorney
Whistleblower lawsuits involving overbilling or other kinds of healthcare fraud can be complex. You might worry about facing retaliation from the nursing home you work at or being unable to find another healthcare job.
Cutter Law in California is a whistleblower law firm that helps nursing home employees report fraudulent healthcare practices.Â
At Cutter Law, you can consult with a whistleblower attorney who will evaluate your case and map out the best strategy. Our free consultations are entirely confidential. Contact us online for more information on how we can help you file a whistleblower lawsuit.
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Our Office Locations
Sacramento Office
401 Watt Avenue Suite 100
Sacramento, CA 95864
Phone: 916-290-9400
Oakland Office
Cutter Law P.C.
1999 Harrison Street Suite 1400
Oakland, CA 94612
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