EHR Whistleblower Reward

Learn About Electronic Health Records (EHR) Whistleblower Reward Eligibility Under the False Claims Act

Healthcare providers, billing administrators, and other personnel who report violations involving electronic health records (EHR) to the federal government may be eligible to receive rewards under the False Claims Act. Former employees and other individuals may be eligible to claim EHR whistleblower rewards as well. If you have relevant information and are interested in seeking a reward for coming forward, our attorneys can explain everything you need to know.

Our attorneys represent whistleblowers nationwide, including those with knowledge of fraud in the electronic medical records industry. We have extensive experience handling whistleblower complaints under the False Claims Act, and we are intimately familiar with the types of EHR-related issues that can warrant claims for whistleblower rewards. As a result, we can help you make an informed decision about whether to come forward; and, if you decide to come forward, our whistleblower attorneys can represent you at no out-of-pocket cost.

Whistleblower Rewards for Reporting EHR Fraud

We help whistleblowers report all types of electronic health records fraud and other violations that compromise patient care to the federal government. These violations jeopardize patient safety and harm taxpayers, and the federal government has prioritized prosecuting all forms of healthcare industry fraud in recent years. Regarding EHR fraud specifically, some examples of the types of issues our attorneys can help whistleblowers report to the federal government include:

• Noncompliant electronic health record systems (including uncertified and fraudulently certified EHR systems marketed by an EHR company)
• EHR software that provides improper clinical decision support (including recommending high-cost alternative treatments and medically unnecessary healthcare services)
• Improper claims for federal incentive payments under the Health Information Technology for Economic and Clinical Health Act (HITECH Act)
• Improper Medicare and Medicaid billings involving inaccurate, forged, or fraudulent EHR 
• Illegal kickbacks and referral fees related to EHR vendors, EHR systems, or patient referrals involving EHR (which may constitute violations of the Anti-Kickback Statute)

These truly are just examples. From fraudulent billings by health care providers under other federal healthcare benefit programs to prescription-related recordkeeping and billing violations, EHR fraud can take many other forms as well. If you think you may be eligible to seek an EHR whistleblower reward for any reason (or if you have questions about whistleblower reward eligibility), we strongly encourage you to contact us for a free and confidential consultation.

Similar to other forms of health care fraud, whistleblower rewards for reporting EHR fraud are available under the False Claims Act. The False Claims Act is a federal statute that prohibits “false” and “fraudulent” claims under government healthcare programs—including Medicare and Medicaid, among others. Some examples of EHR-related violations that can constitute false and fraudulent claims include:

• Overbilling Medicare or Medicaid (including intentional and unintentional upcoding, unbundling, and phantom billing)
• Overbilling other federal healthcare benefit programs 
• Seeking EHR incentive payments for medical providers in violation of the federal certification and “meaningful use” requirements 
• Paying (or offering to pay) kickbacks or referral fees out of program-reimbursed funds 
• Accepting (or soliciting) kickbacks or referral fees to be paid out of program-reimbursed funds 

Under the False Claims Act, individuals who report these (and other) types of false and fraudulent claims are entitled to a financial reward if their report leads to a successful enforcement action. Generally, EHR whistleblower rewards are between 10% and 30% of the amount the government recovers—with all rewards falling into one of three broad categories:

• 10% to 15% of the Government’s Recovery – A reward of 10% to 15% may be issued in cases in which the whistleblower was personally involved in the wrongdoing disclosed. If you are considering reporting EHR fraud in which you were personally involved, this is something that you will want to discuss with your attorney before you file. 
• 15% to 25% of the Government’s Recovery – Most EHR whistleblower rewards fall in this range. If you file a qui tam complaint under the False Claims Act and the government pursues a successful enforcement action based on the information you disclosed, you will generally be entitled to 15% to 25% of the amount recovered (unless you were personally involved).
• 25% to 30% of the Government’s Recovery – If you file a whistleblower complaint and the government decides not to pursue the case, you will have the option of pursuing your case on your own (in this scenario, experienced legal representation is essential). If your case is successful, you will be entitled to 25% to 30% of the amount recovered. 

Within each of these categories, the specific percentage of an EHR whistleblower reward is determined based on the importance of the information disclosed in the original qui tam complaint, the whistleblower’s involvement in the government’s investigation, and other factors. If you decide to file a qui tam complaint, our attorneys can assist you with taking the steps necessary to report fraudulent electronic health records-related practices and provide the additional assistance necessary to seek a whistleblower reward.

Put our highly experienced team on your side

Dr. Nick Oberheiden

Founder

Attorney-at-Law

Lynette S. Byrd

Former DOJ Trial Attorney

Partner

Brian J. Kuester

Former U.S. Attorney

Hon. Kevin McCarthy

55th Speaker, U.S. House of Representatives (ret.)

Government Consultant

Mike Pompeo

Of Counsel

Former U.S. Secretary of State

John W. Sellers

Former Senior DOJ Trial Attorney

Linda Julin McNamara

Federal Appeals Attorney

Nicholas B. Johnson

Former Prosecutor

Roger Bach

Former Special Agent (DOJ)

Chris J. Quick

Former Special Agent (FBI & IRS-CI)

Michael S. Koslow

Former Supervisory Special Agent (DOD-OIG)

Ray Yuen

Former Supervisory Special Agent (FBI)

How to Seek an EHR Whistleblower Reward

If you are interested in seeking a reward for reporting an EHR fraud or another EHR-related violation to the federal government, there are some important steps you should take promptly. These steps include:

1. Protect the Information You Have in Your Possession

First and foremost, you should protect the information you have in your possession. At this point, you should not share this information with anyone other than your whistleblower lawyer.

2. Be Very Careful About Taking or Copying Any Additional Information

You will need to be very careful about taking or copying any additional information from your employer’s facilities, systems, or servers. We strongly recommend consulting with a lawyer before you do so.

3. Take Detailed Notes

You should take detailed notes about why you suspect EHR fraud or another EHR-related violation. Do this while the information is still fresh in your mind, and keep your notes in a safe place as well.

4. Schedule a Free Consultation with an EHR Whistleblower Lawyer

If you are interested in blowing the whistle on fraud in the health care or EHR industry and seeking a reward under the False Claims Act, you will want to seek advice from an experienced lawyer. You can get started with a free consultation.

5. Be Prepared to Work with Your Lawyer to Make Informed Decisions

If you decide to move forward with filing a qui tam complaint under the False Claims Act, you will need to be prepared to work closely with your lawyer to make informed decisions throughout the process.

FAQs: EHR Whistleblower Rewards Under the False Claims Act