People who witness fraud in the respiratory industry may hesitate to come forward out of fear. This is a valid concern; we have all heard stories of people being retaliated against, or punished in some way for speaking up for what is right.
However, there are laws and acts in place that protect whistleblowers from potential adverse reactions by employers. There are also steps that potential whistleblowers can take to make sure they are protected and ensure confidentiality of all consultations and proceedings.
What protections exist for whistleblowers in the respiratory industry?
There are laws in place for the sole purpose of protecting whistleblowers that would like to learn how to report respiratory fraud. They include:
The False Claims Act
The False Claims Act (FCA) is a federal law that makes it illegal for any person or organization to make a false record or file a false claim in order to obtain reimbursement from programs like Medicare, Medicaid, or Tricare. Under the FCA, individuals who report a violation are protected from discrimination, harassment, suspension, or termination.
The Whistleblower Protection Act
The Whistleblower Protection Act (WPA) was passed in 1989 to — as the name implies — protect whistleblowers. Under the WPA, federal employees cannot have punitive action taken against them by their employers for coming forward with information that evidences:
- A violation of law or regulation
- Gross mismanagement or waste of funds
- An abuse of authority
- A threat to public health or safety
The WPA applies to current employees as well as applicants.
Whistleblower Protection Enhancement Act (WPEA)
In 2012, Congress passed the WPEA to strengthen the WPA. There were grey areas where it was unclear whether or not the whistleblower was protected, so the enhancement made the following clarifications: In an individual is still protected by the WPA…
- Even if disclosure was made to someone involved in the wrongdoing.
- Even if wrongdoing has already been disclosed by someone else.
- Regardless of the reporter’s motive.
- Even if the disclosure was made while the individual was off duty.
- Regardless of the amount of time that has passed since the wrongdoing.
- If the report is in regards to censorship of research, analysis, or technical information that exposes wrongdoing.
OSHA
OSHA has a Whistleblower Protection Program (WPP) that prohibits employers from firing, laying off, demoting, denying overtime or promotion, or reducing pay or hours for anyone who takes actions protected by the WPP. The WPP includes over 20 statues of protection which you can find here.
Tips and advice from the experts
For those considering blowing the whistle on fraud in the respiratory industry, consider the following tips and pieces of advice for maintaining the highest level of protection and confidentiality:
Know the fraudulent activities you can report
Some examples of fraud within the respiratory industry include:
- Data mining
- Billing for non-compliant patients
- Waiving co-insurance
- Billing for products or services that never occurred
- Forging or changing medical orders to receive payments for respiratory devices or treatments
- High-pressure sales tactics
- Avoiding lawful return of equipment
- Multiple billing for home sleep tests
Note that this list isn’t exhaustive, but it contains the most commonly seen instances of fraud.
Consult with a leader in whistleblower representation
Once you’re certain you have a case that warrants reporting, it’s important to consult with an attorney who specializes in helping whistleblowers report respiratory fraud. They will know the proper course of action to follow whistleblower protection laws. They also can guarantee confidentiality while working hard to secure a financial reward for your bravery whenever possible.
Nobody should hold back information about fraud or wrongdoing out of fear. There are protections in place to make sure you don’t face any negative repercussions. Attorneys like the team at the DJO Whistleblower Law Group can guide you through the process, making you feel comfortable and secure the entire time.
Find out more by contacting us today.
