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Healthcare Fraud FAQs

We are healthcare fraud attorneys at Brewer & Pritchard who understand you have concerns about what to do if you suspect wrongdoing. You may be concerned about the ramifications of becoming a whistleblower. You may have questions. To help you, we are providing the following frequently asked questions about healthcare fraud. If you have other questions or are aware of fraud or abuse, contact a whistleblower attorney at Brewer & Pritchard today.


What is healthcare fraud?

Healthcare fraud is a crime committed by people or institutions to turn a profit. The defrauding of programs such as Medicare, Medicaid and TRICARE, the healthcare program from the military, costs the United States billions of dollars per year. Healthcare fraud schemes not only hurt taxpayers, but may harm patients who may receive unnecessary treatment from a medical care provider.

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Can you explain the False Claims Act?

Federal and state false claims acts allow qui tam whistleblowers to take action against individuals and companies that defraud governmental programs, including healthcare programs such as Medicaid, Medicare and TRICARE.

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What does the term qui tam mean?

Qui tam is a Latin term used to describe an action by a private individual who assists in a prosecution (a whistleblower). The False Claims Act contains a qui tam provision that allows the private individual who has knowledge of healthcare fraud to receive part of the penalty imposed.

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What does "relator" mean?

The person named in a qui tam case is referred to as the "relator," or whistleblower.

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How much money do whistleblowers receive in healthcare fraud lawsuits?

Whistleblowers potentially can receive millions of dollars, but compensation depends on the size of the fraud and what the government collects under a False Claims Act case. Relators typically receive 15 percent to 30 percent of the government's recovery, including damages and civil fines. According to the Department of Justice, recoveries in all qui tam cases in 2014 nearly reached $3 billion. Whistleblowers received $435 million.  That year, healthcare fraud cases resulted in $2.3 billion in recoveries.

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Why do I need to talk with a healthcare fraud lawyer?

Healthcare fraud cases are complex. Typically, the defendants are large corporations. They sometimes are hospitals or pharmaceutical companies with deep pockets and teams of highly skilled lawyers looking out for their best interests. An individual whistleblower will need an attorney with knowledge of this specialized area of the law.

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Why should I choose Brewer & Pritchard?

Brewer & Pritchard has experience handling all types of federal court cases, including cases involving the False Claims Act. When we represent whistleblowers, we assist in putting together cases and filing their complaints. We help the Department of Justice investigate so prosecutors have critical information.  J. Mark Brewer, principal and co-founder of Brewer & Pritchard, has tried cases in federal and state courts and has take trials to bench and jury. He has helped clients obtain multi-million-dollar recoveries. Our firm is based in Houston, TX, but we handle cases throughout the country.

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Why should I become a whistleblower?

By "blowing the whistle," you are taking a stand against corruption, fraud, greed and waste. You are playing a key role in punishing unscrupulous companies. It's an honorable undertaking - one that requires courage. Of course, you may face a backlash from the company or may even risk your career. That's why the government provides a generous financial incentive. You may be eligible to collect a portion of the government's recovery, which could amount to millions of dollars.

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