Unfortunately, South Carolina does not have a state false claims act. However, when fraud or illegal claims are made against the government, most of the time, such claims include federal programs. One common federal program that is often a victim of fraudulent or illegal claims is the federal Medicare Program. Almost every medical provider that provides medical services bills both Medicare (federal) and Medicaid (state) programs. The federal False Claims Act prohibits false claims involving federal programs.
When a federal False Claims Act complaint is filed, it is filed in federal court. South Carolina has federal courts located in Aiken, Anderson, Beaufort, Charleston, Columbia, Florence, Greenville and Spartanburg.
The FCA allows a whistleblower’s name to remain anonymous when the complaint is filed. The complaint is filed under seal, meaning in secrete, until the government decides whether to adopt the case. The whistleblower, called the “relator,” can receive and award of up to 30% the recovery if the government does not adopt the complaint. If the government choses to adopt the compliant, the relator is entitled to an award of up to 25% of the award.
When a person or business violates the False Claims Act, the wrongdoer is often responsible for paying treble damages. For example, if a medical provider fraudulently billed Medicare in the amount of $3 million dollars, the medical provider could have to pay $9 million back to the federal government. In this scenario, the whistleblower’s award could be $2.7 million, if the govern declines to adopt the case, and $2.25 million if the government adopts.
Whistleblower Protection Against Retaliation
The False Claims Act has an anti-retaliation provision that protects the whistleblower from acts of retaliation by an employer. For reporting fraud, the whistleblower can not be “discharged, demoted, suspended, threatened, harassed or in any other manner discriminated against in the terms or conditions of employment by his or her employer.”
An employee, contractor or agent of the company may be entitled to (1) reinstatement of employment; (2) two times the amount of back pay, including interest; and (3) an award for special and compensatory damages, including reasonable attorneys’ fees.
Before deciding to report fraud against the government, a potential whistleblower should seek legal advise to ensure the disclosure is made in accordance with federal law. Failure to do could result in the loss of the whistleblower’s share of any recovery.
If you are considering whether or not to blow the whistle, contact us at Miller Law Group, or call 919-348-4361 for a free consultation.