Has healthcare fraud crossed your path at work and made you want to take action? Understanding the “first to file” rule can be critical to the success of your case—and to increasing your odds of collecting a reward for your whistleblower claim.
This guide will help you understand why filing early is so important and will lead you through important steps in establishing your place as the first to file.
Why It Matters to Be the First to File a False Claims Act Healthcare Case
Being the first to file a healthcare fraud claim may be decisive in the result of your case. Not only that, but it can certainly assure that your information is taken seriously and that you’re first in line for potential rewards.
Here’s why being first to file is so important:Â
- Competitive Edge. The adage “The early bird gets the worm” is not a cliché when it comes to whistleblower law. Timing is everything in whistleblower claims. Having a first whistleblower lawyer report regarding a violation provides an important competitive edge. With the first to file status, you acquire specific rights that subsequent filers do not. The False Claims Act (FCA) specifies that these rights have a material bearing on the reward you could receive.
- Increased Rewards. Reporting violations early puts the wheels of justice in motion and positions you for a larger reward if the government recovers funds based on your report. In other words, the earlier you contact a whistleblower law firm and the earlier you make an official filing with them, the better your chances of making a big difference and earning a big reward.
- Shared Rewards. Not the first to file your claim? No worries! Sometimes, a second whistleblower may still receive a portion of the reward granted to the first filer. But this is never a guarantee. That’s why it’s crucial to come forward with your information as soon as possible to maximize your potential reward.
How Reporting Healthcare Fraud Pays Off
There are many examples where the first to report has also seen their case succeed. Typically, whistleblowers who work quickly and decisively are better protected and rewarded in the long run.
For instance, in 2023, Cigna Group agreed to pay over $172 million to settle allegations that it violated the False Claims Act by submitting and not retracting false and misleading diagnosis codes for its Medicare Advantage Plan enrollees to boost Medicare payments.
The Medicare whistleblower who contributed to the discovery of the fraud will be awarded more than $8.1 million from the settlement for revealing the misconduct.
How to File a Whistleblower Complaint
It cannot be emphasized enough that you should file your whistleblower complaint as early as possible. Early action enhances your credibility and prevents others from filing a claim based on the same fraudulent activity.
Due to the first to file rule, it is advisable to have all your documents prepared and to see a whistleblower attorney very early in the process. Once you have this, you are good to go, and you can follow the procedure to ensure your case is timely and valid.
Steps to Take To File a Healthcare Fraud Case
- Have Expert Guidance. From the first time you suspect fraud, see a whistleblower attorney. At DJO whistleblower law firm, we offer confidential and no-obligation consultations on your case. This step is critical because you will be in a position to understand your rights and prepare a strong claim.
- Gather Information & Evidence. You will need detailed evidence to make a strong case. Your lawyer can help you determine which evidence to gather. This could be emails, billing records, or any other material that helps prove your case. The stronger your evidence, the better the chances of your claim being successful.
- File a Claim. Once you have gathered enough evidence, your attorney will walk you through all the important steps of officially filing your whistleblower claim. This action formally sets the investigation in motion.
- Let the Authorities Investigate. After filing, the government fully takes on the investigation process. Your part is only to offer support and information as may be needed to ensure the investigation goes on smoothly.
- Receive a Huge Reward. Should your information be critical in recovering funds, you might be eligible for a significant reward. Under the FCA, one can be rewarded up to 30% of the recovered fund. This means that your boldness and timeliness can be turned into an opportunity for a significant financial reward!
Are You Ready to Report Healthcare Fraud?
Filing first in a healthcare fraud whistleblower case puts you in a position to receive not only a monetary reward but also legal protection for your role in the case. Time is of the essence in a False Claims Act whistleblower case, so it’s important to act quickly and wisely.
DJO’s highly experienced team of whistleblower experts and attorneys and even former whistleblowers work together to ensure the highest cash award to individuals with the kind of information that can blow the lid off of fraud. As a contingency law firm, we don’t take a penny unless you do.
Take the next step and contact us for a no-obligation, confidential consultation regarding your case and the strategic advantages of filing first. Your information could make all the difference in fighting healthcare fraud.
authored by Christopher J. Piacentile
Director of Investigations DJO Whistleblower Law Group
