Whistleblowers in Colorado Nursing Homes

The federal government’s jurisdiction is vast, but they cannot be everywhere at once. To incentivize private citizens to report fraudulent activity, the government gives everyday people the option to partner with them to file a whistleblower lawsuit and retain a portion of the final settlement.

Given the need for Medicare in nursing homes across the country, several nursing homes have been found guilty of trying to cheat the system by submitting false claims.

Here’s more on whistleblower lawsuits and how to file one if you suspect fraud.

What is a Whistleblower Lawsuit?

A whistleblower, or qui tam, lawsuit is a claim filed under the False Claims Act (FCA). These lawsuits allow people to report on FCA violations for the government. The government will investigate once someone (known as the relator) files the suit. If they win the case, they will award a portion of the money recovered to the whistleblower.

Nursing homes are notorious for committing FCA violations. Whistleblowers have recovered substantial compensation over the years for reporting these misdeeds.

Common Issues That Warrant a Whistleblower Claim

The National Whistleblower Center lists the following FCA violations:

• Charging the government for more than what was provided
• Fraudulently seeking a government contract
• Submitting a false application for a government loan
• Submitting fraudulent applications for grants of government funds
• Demanding payment for goods or services that don’t conform to contractual or regulatory requirements
• Requesting payment for goods and services that are defective or of lesser quality than were contracted for
• Submitted a claim that falsely certifies that the defendant has complied with a law, contract term, or regulation
• Attempting to pay the government less than is owed

In the context of a nursing home, Medicare fraud is most common. According to Medicare.gov, nursing homes might commit FCA violations by:

• Stealing a resident’s Medicare number and using it to make fraudulent claims
• Billing Medicare for services residents never received
• Charging residents twice for the same service
• Offering Medicare drug plans to residents that Medicare hasn’t approved 

Are You Protected as a Whistleblower? 

Many avoid filing a qui tam lawsuit for fear of retaliation from their employer. However, the False Claims Act provides relief for any retaliation victims because of a qui tam lawsuit. That could include anyone discharged, demoted, suspended, threatened, or harassed because they filed a qui tam lawsuit against their employer.

Forms of retaliation relief might include:

• Reinstatement with the same seniority status you would have had without the discrimination
• Two times the amount of back pay with interest
• Compensation for special damages as a result of the discrimination
• Compensation for attorney fees

If you’ve experienced retaliation, Colorado law allows you to file a whistleblower complaint form within ten days of the disciplinary action. 

How to File a Whistleblower Lawsuit in Colorado?

The Department of Justice outlines the requirements to start a qui tam lawsuit. You must file the civil complaint under seal with the court and serve a copy of the complaint and a written disclosure of all material evidence on the Attorney General and the United States Attorney. After you’ filed your claim, the government has 60 days to decide whether they want to pursue the case. It’s vital to gather any necessary evidence that could benefit your case during this period and turn it over to government officials. 

How Much Compensation Can You Receive in a Whistleblower Claim?

The amount you recover in a whistleblower lawsuit will depend on the final settlement amount and the government’s involvement. Under the qui tam provision of the False Claims Act, the whistleblower is entitled to 15-25% of the final recovery amount. The government will compensate you for all your attorney fees.

One example of a whistleblower lawsuit in recent years involved a former employee who filed a qui tam lawsuit against an employer engaged in Medicare fraud. The at-fault company agreed to settle for over $5.5 million. This amount is not always guaranteed, but it does offer insight into a qui tam claim’s potential.

Get Help Filing a Whistleblower Lawsuit

If you suspect your employer is defrauding government programs like Medicare, contact Nursing Home Justice today. Our lead attorney, Mac Hester, will meet with you personally to hear the details of your case. He can help you file your claim. Call today at (970) 493-1866 for a free consultation.