Dolman Law Group is an award winning Clearwater car accident and personal injury law firm. Matthew Dolman has been selected as a Florida Super Lawyers in 2013, 2014 and 2015 by his colleagues. Mr. Dolman has been nominated as a top 100 trial attorney and top 40 under 40 by National Trial Lawyers. He is a lifetime member of both the Million Dollar and Multi-Million Dollar Advocacy Forum.
Friday, March 27, 2015
What is a Whistleblower?
Fraud is a
very broad term. When you hear about someone “defrauding the Federal government”,
you might imagine a complex mafia-like operation going on behind secure doors.
With the way Hollywood movies portray everything, it can be hard to envision
fraud in a realistic way. It’s not uncommon for people to go their whole lives
completely unaware that even the largest, most successful companies partake in
illegal or fraudulent activities on a regular basis. On top of that, their acts
of fraud can even be a large reason for that company’s success. However, if and
when they get caught, or when a “whistleblower” speaks out and gives the
government insider information, the harsh consequences are usually justified.
Governmental fraud is an epidemic and the cause of lots of lost taxpayer money.
However, because fraud is not easily detectable, it often goes unnoticed. We
taxpayers rely on brave whistleblowers to present and prevent fraud. To get an
idea of how much of an impact it has had on our nation, take note that our
Federal government has recovered over $40 billion since 1987 through a
countless number of False Claims Act (FCA) lawsuits.
Despite how it may appear in the media,
it’s important to know that this organized deception doesn’t always deal with
identity theft, stolen credit cards, and tax evasion. The same word—fraud—is used for all levels of
fraudulent activities, from trivial to momentous ones—with differing civil and
criminal specifications. In its most simple form regarding tort or civil law,
fraud can be described as “the intentional misrepresentation or concealment of
an important fact upon which the victim is meant to rely, and in fact does
rely, to the harm of the victim.” In other words, an entity or
organization cannot intentionally lie about something that another entity or
organization must and will rely on. If an innocent consumer uses a product or
service with the implied or given understanding and belief that said product is
“safe”—even though the company supplying that product or service factually
knows or believes otherwise, but either continues to misrepresent, or fails to
prevent the misrepresentation—and that consumer is later injured in a way that
contradicts what has been stated about the product or service and its qualities;
that’s fraud for sure.
Need a real world example to understand civil fraud?
A fictional eatery by the name of Restaurant
A houses certain food products which contain some sort of peanut
ingredient. However, since business is hurting recently, they’ve made the bold
decision to advertise themselves as “the only 100% peanut-free restaurant in
the world!”Luckily for them, no one with severe peanut allergies has eaten
there, so they’ve yet to get caught in the act of deception. The brave Employee
A is fully aware of the lies; he knows for sure that certain foods at
the restaurant contain peanuts. He knows it’s a marketing attempt to wrongly
attract more customers. Restaurant Afalsely advertising itself as
“peanut-free” would be the “intentional misrepresentation” in this scenario.
Customer Awalks in and
is the first customer of many to be victim of this intentional deception. She’s
got severe peanut allergies, but she’s excited to try multiple food items from
the peanut-free restaurant as she’s had troubles in the past. This customer is
“meant to rely” on the fact that there’s no peanut-based products used in the
food, and will therefore be safe for her to consume. Of course, once the
allergen reaches her system, she has a violent allergic reaction and must be
sent to the ER. Customer A could have
a products liability case against the restaurant, but she likely has no idea
what went wrong. It couldn’t have been an allergic reaction to peanuts, because
that restaurant is peanut-free, right? Well; that’s where things get
complicated, investigators get involved, and a class action begins.
However, let’s focus more on the
whistleblower aspect of this whole thing. If it’s never determined that Restaurant A is lying about being pure
of peanut-based ingredients, how will the allergic reactions ever stop? Without
the insider information that Employee A
has, the government may never suspect any wrongdoing on the restaurant’s end.
Will this employee make the brave choice to “blow the whistle” and force the
company to face the consequences of their fraudulent and harmful choices? He
could lose his job; he risks the chance of ever working in the restaurant
business again. Not only that, but his efforts may be shot down; leaving him
not only empty handed, but out of a career. Is it worth it? Let’s delve deeper
into the characteristics of a whistleblower.
So what makes a whistleblower, a whistleblower?
Just like fraud, the
term whistleblower is very vague. You may imagine conspiracy theorists or sports
coaches, but in reality, the meaning goes much deeper than that. Occasionally,
whistleblowers can be viewed as heroes, exposing the most severe levels of
fraudulent activities within an organization. Other times, whistleblowers can
be fraudulent themselves. Intentionally hurting an entity’s reputation by
writing or through spoken word is known as defamation; libel and slander respectively. So don’t go blowing that whistle all over the place!
If you’re interfering with the entity’s business or operation (i.e. making it a
public matter instead of a governmentally “protected disclosure”), you might
get yourself in to some trouble unless you can undoubtedly prove that you speak
the truth. Proving something like that is no easy task these days.
What sets apart a governmental
fraud whistleblower from the likes of a conspiracy
theory whistleblower is the False Claims Act, as mentioned in the first
paragraph. This act covers pretty much anything and everything that has to deal
with the government losing funds due to deception. Additionally, it very much
protects the whistleblower (appropriately known as a relator) by keeping everything sealed. A correctly presented and
legitimate lawsuit under the False Claims Act brought forward by a relator will
be kept confidential. If your employer were to discover your intentions of
uncovering their fraudulent activities, they may feel pressured to retaliate.
However, a relator can have some peace of mind knowing that they are protected
from any retaliation (i.e. position termination, demotion, suspension, etc.)
through the FCA. Lawsuits regarding the FCA brought forward by relators
(whistleblowers) are known as Qui Tam lawsuits.
When should I blow the whistle?
If you find out that your boss is overcharging a few customers
here and there, don’t be too quick to report him to a Federal agency in hopes
of getting a few bucks in return. Successful Qui Tam lawsuits require more than
that, and furthermore, your play-by-plays have to be kept quiet. The
information regarding suspected fraud that you possess and plan to share has to
be original and lead to the recovery of at least $1 million in order for you to
get a cut of it. Assuming that your tip(s) leads to the uncovering of fraud on
that large of a scale, you could be looking at a 15 to 30% split of the
recovered financial losses. What would have to be determined next is whether or
not that “split” is worth risking your career over. When all the cards are
drawn and the action is over, who will come out on top? As a whistleblower, you
should have your eyes set on punishing a company for their unethical and unjust
actions and recollecting a potentially significant amount of taxpayer dollars
for the government, rather than profiting from a sticky and suspicious
situation you’ve found yourself in.
With that said, it’s very important to have your facts straight
and to keep your intentions on the down-low. Big companies or organizations
that have gotten away with defrauding the government for long periods of time
are clearly experienced at it. If they were to learn of an impending fraud
investigation, they could be inclined to set up some serious defense. When
you’re on your own, it will be no small feat to end an organization’s
fraudulent activities. In fact, many whistleblowers are offered “hush money” to
back off and “call it even”. Sadly, the temptation can get the best of a
nervous or inept whistleblower—they accept the bribe and the fraud continues,
maybe on a greater scale than before. Don’t be tempted; don’t be scared; speak
up! It may seem like an impossible feat, but remember that there are many paths
for assistance. An experienced qui tam lawyer can be of great assistance to you
by offering a free consultation and case evaluation which is kept completely
confidential. By taking advantage of this offer, you can learn as soon as
possible if your decision to pursue a wrongdoer for fraud is poor, fair, or
smart. If you’re interested in that offer, contact a qui tam litigation
What are some examples of fraud that I should be aware of?
A growing concern, and the ones which deal most directly with the
health and well-being of innocent people, are the medical-related categories.
Health care fraud has and will likely always drain taxpayer dollars
significantly. The same goes for the pharmaceutical industry, with fraud being not only
common, but expected. Medicare Part D goes hand in
hand with pharmaceuticals. Here are a few examples of ways that health care
providers, medical practices, surgery centers, and more are defrauding not only
their fellow taxpayers, but the nation as a whole:
Health Care Fraud: Often times, medical providers will:
Overcharge for medical
Charge for procedures that were
Charge for procedures that
didn’t need to be done.
Because the government lacks medically-trained professionals that
can scout each individual practice to ensure cooperation and non-fraudulent
activities, they heavily rely on whistleblowers with personal involvement to
step forward and assist them.
(Example: Boss A
pressures his employees at his medical practice to perform x-rays on as many
people as possible. Getting an x-ray scan can be an expensive procedure and,
when performed on someone who doesn’t really need it, can lead to the victim of
fraud (or his Federally-funded health insurer) paying unnecessary medical bills
to the practice.)
Pharmaceutical Industry Fraud: Big Pharma companies like Johnson
& Johnson, Pfizer, and GlaxoSmithKline know how to make big money using
fraudulent methods such as:
Marketing their drug for uses
that were not approved by the FDA.
Bribing or winning the favor of
hospitals or physicians to prescribe their drug to patients.
Manipulating or concealing the
true sale price of their drug to get higher payouts from Medicare.
Unfortunately, millions of Americans rely on prescription drugs to
continue living. Because they need these drugs, patients will often turn
a blind eye to suspicious activity, completely unaware that they’re being taken
Company A sells their drug in bulk to Drug
Wholesaler A for a significantly lower price than they would anyone else.
The government requires that Pharmaceutical
Company A sells to Medicaid programs at the same rate of the best deal
they’ve given anyone else. Instead of being honest about it, Pharmaceutical Company A does the deal
with Drug Wholesaler A under the
table and fails to record the final sale price, therefore giving the Medicaid
program an incorrect or nonexistent sales history to base their buy price on.)
Medicare Part D Fraud: This type of fraud has many of the same
characteristics of pharmaceutical fraud.
(Example: Doctor A is
paid-off by Pharmaceutical Company A to
pressure patients into being prescribed a newer, updated prescription to treat
their condition. Patient A is pleased
to hear all of the benefits, and so agrees to take the drug. His
Federally-funded Medicare Part D covers the cost of these brand-name pills, but
he’s actually given a generic alternative. The patient has no idea, the
government has no idea, but both Doctor A
and Pharmaceutical Company A pocket
some extra taxpayer dollars.)
SPEAK WITH AN EXPERIENCED QUI TAM ATTORNEY IN THE CLEARWATER & TAMPA
BAY AREA FOR FREE
Whether you’re working for a private
medical practice or a large surgery center, it’s possible that you’ve witnessed
fraudulent activities occur around you. If that is the case, you may be
hesitant to move forward or speak out, but don’t be. Here at Dolman Law Group,
we strive to make you feel comfortable with your choice to become a relator and
assist in the uncovering of governmental fraud. If you believe you have
information that could lead to such actions, you shouldn’t hesitate to get in
Our team of experienced qui tam
litigation attorneys can help you decide which course of action is in your best
interest and will ensure your anonymity. If you expose fraud against the
government, you could be eligible to receive significant financial compensation.
For more information, or to get in touch with an attorney today, use our
website or give us a call at 727-451-6900.
Dolman Law Group 800 North Belcher Road Clearwater, FL 33765 (727) 451-6900