Can a hospital or medical clinic bring a State licensing board complaint against a whistleblower for blowing the whistle on fraud and/or substandard care?
Unfortunately, this is an all too often strategy used to discredit those who seek to take a stand in protecting their patients and their own professional licenses.
The Federal False Claims Act (FCA) provides protection for whistleblowers against retaliation. However, it is necessary for a skilled attorney to be brought on early in the fraud reporting process to provide the strong legal armor needed to fend off the desperate attempts of civilly and criminally liable fraudsters.
The FCA allows an individual with evidence of fraud against the federal government, to sue the perpetrator to recover the stolen funds and is rewarded by a percentage of the funds recovered. Prohibited retaliation includes: termination, suspension, demotion, harassment or any other discrimination in the terms and conditions of employment. In order to prevail, an employee must prove: (1) that the employee took action in furtherance of an FCA action; (2) that the employer knew about these acts; and (3) that the employer discriminated against the employee because of such conduct.
A person with knowledge of a scheme to defraud government health programs such as medicare, medicaid, and tri-care is essentially between a rock in hard place. If a person ignores the fraud exists, they may be implicated later for being complicit with the scheme, lose their state license, and face the embarrassment of a government probe, or they can retain an attorney with skill and knowledge on the Federal False Claims Act so that they may retain their rights and earn a portion of the money recovered.
The correct strategy is to consult an attorney prior to taking steps and actions that may lead you into the traps that are carefully laid to discredit the whistleblower and strip them of their professional credentials.