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AG encourages whistleblower lawsuits to fight fraud

August 19, 2010
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The Indiana Attorney General’s Office wants health care and pharmaceutical industry workers to know that they have the ability to file lawsuits and get protection as whistleblowers, and that could mean getting a portion of any settlement or damages that results from the suit.

With Medicare and Medicaid fraud a multi-billion dollar problem nationally, the state’s highest attorney is reaching out to workers who may be impacted by these issues to alert them of their rights as whistleblowers in stopping this type of state and federal fraud.

Attorney General Greg Zoeller is trying to raise public awareness on the topic, which comes as the health care and pharmaceutical industries face sweeping reforms in the coming years and more people are exposed to these scenarios.

“The idea is to persuade workers already concerned about fraud to raise those claims under the False Claims Act,” Zoeller said. “If individuals on the inside are aware of fraud … and reporting it internally has not stopped the fraud, they may be reluctant to come forward for fear of being ostracized from future employment in their chosen profession. While we would hope people would report fraud because that’s the right thing to do, we understand that the potential of a substantial financial reward may be necessary to prompt insiders to come forward.”

The AG’s Medicaid Fraud Control Unit is supervising the effort, which involves the False Claims Act that’s existed in federal and state law for years and applies to government contract work. A whistleblower action starts when someone like an employee files a private lawsuit against a provider or company, alleging that business committed fraud on a government contract. That employee-plaintiff basically brings the suit on the government’s behalf, the AG said. If the government wins at trial or reaches a monetary settlement with the provider or company where the fraud occurred, then that whistleblower may receive 15 to 30 percent of the proceeds.

During the past year, the state has been involved in a handful of these whistleblower actions that have alleged billions of dollars in fraud, according to the AG’s Office. Those include suits against Pfizer, Eli Lilly, AstraZeneca Pharmaceuticals, and the South Bend mental health services facility called Madison Center. Some causes have been settled while others remain ongoing.
 

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