Health care providers and whistleblowers: Basics on protections and investigations of misconduct
Compliance Today
July 1, 2009
James W. "Jim" Michalski- Los Angeles
William M. "Will" Pannier- Los Angeles
Since the strengthening of the False Claims Act in 1986, efforts to root out fraud against government-funded programs have resulted in recoveries totaling more than $21 billion – most of it coming from the health care industry. Company-enacted compliance and ethics programs have become vital tools to help health care facilities and providers prevent misconducts such as fraudulent billing practices and submitting claims for tests that were not provided or medically unnecessary. Employees are encouraged to report such transgressions as well, but employer retaliation for participating in an investigation or holding information about potential violations is a very real concern. This article outlines the specific whistleblower protections that exist, particularly in the health care field. Additionally, it supplies guidance on who should be conducting the investigation and the advantages of engaging outside counsel. To read the full article, please click the link below.
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