Healthcare Reform Law Changes Encourage Whistleblower Lawsuits

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Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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UPDATED: Jul 16, 2021

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The Anti-Kickback Statute and Qui Tam Public Disclosure Bar amendments to the new Healthcare Reform Law have a direct impact on whistleblower, or Qui Tam, lawsuits that expose fraudulent activity against the government – especially in the healthcare industry – which Qui Tam attorneys (link to say has been subject to some of the largest False Claim Act (FCA) settlements in history. Here’s what the amendments mean:

Anti-Kickback Statute amendments

The following fraud and abuse amendments to the Anti-Kickback Statute of the Healthcare Reform Law provide that:

  • Violations do not have to be intentional. An AKS violation may be established without showing that an individual knew of the statute’s prohibitions or intended to violate it.
  • Manufacturers may share in the liability. A violation of the statute constitutes a false or fraudulent claim under the False Claims Act – which may affect manufacturers who don’t submit actual claims to the government.
  • More healthcare industry violations may be subject to FCA. The beneficiary inducement statute now applies to providers, practitioners, suppliers, health plans and healthcare service entities and may make many health care industry activities subject to False Claims Act violations.

Qui Tam Public Disclosure Bar amendments

The following amendments to the Qui Tam Public Disclosure Bar of the Healthcare Reform Law provide that:

  • Public disclosure bar is not jurisdictional. The public disclosure bar has been amended and is no longer jurisdictional and does not require dismissal if the government opposes dismissal.
  • Direct knowledge no longer required. The whistleblower, or relator, used to have direct and independent knowledge of the fraudulent activity in order to file a Qui Tam lawsuit according to the original source definition. The amendments now provide that the relator must simply provide the information to the government prior to the public disclosure and that the information must be independent of and materially add to the publicly disclosed allegations.

All of these amendments potentially make filing a whistleblower lawsuit easier – which not only benefit the government, but also the whistleblower.

Whistleblower settlements & verdicts

Whistleblowers generally collect a substantial percentage of what was recovered – and many whistleblowers have collected millions of dollars for their efforts. If you know of fraudulent activity against the government, contact an experienced Qui Tam lawyer to discuss your situation and find out how the whistleblower process works.

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