Section 1558 protects workers who report health violations to employers, the federal government, or prosecutors from retaliation, including reporting violations of new laws that prohibit denial of coverage under existing conditions. The whistleblower will receive remedies similar to those provided under the Federal False Claims Act, including, but not limited to, remedies, compensation, special damages, and legal fees.
Under federal law and the False Claims Act, complainants can file lawsuits on behalf of the federal government to make false claims under Medicare. Similarly, many states have false information laws that allow you to report false information about Medicaid. You can contact us today to know how the ACA provides benefits in healthcare claims.
With a few minor differences, most government fraud claims are like the Federal False Claims Act, which demands large damages for fraudulent invoices. A whistleblower's claim is known as a qui-tam lawsuit and legally results in a report of irregularities between 15-25% of any refund based on the direct knowledge of a reliable complainant. In cases where the complainant is allowed to proceed on his own, he can receive up to 30% of the reimbursement due to his efforts and participation in the process.
While the Affordable Care Act provides for many new criminal and civil sanctions and new tools to combat health fraud, whistleblower protection provisions tend to be the most extensive and controversial. As news of increased protection against fraud spreads, more and more people learn about health scams. No matter what you think about health reform, that's a good thing.