Damages from fraud can be recovered by use of the False Claims Act, most commonly under the qui tam provisions which rewards an individual for being a "whistleblower", or relator (law).
[1] The FBI estimates that Health Care Fraud costs American tax payers $80 billion a year.
[5] In this case a provider does not submit exactly the same bill, but changes some small portion like the date in order to charge Medicare twice for the same service rendered.
This could be a small cash kickback for the use of an MRI when not required, or a lavish doctor/patient retreat that is funded by a pharmaceutical company to entice the prescription and use of a particular drug.
[5] Other forms of payment that could be illegal kickbacks include paid speaking positions at events, consulting contracts, and research grants.
The whistleblower was able to provide detailed insider information as to the nature of the kickbacks, which ranged from entertainment to sporting event tickets and other gifts.
[citation needed][9] Copied and pasted entries into the Electronic Medical Record may constitute fraud.
[10] The settlement resolved allegations that the company marketed and sold cancer drugs Thalomid and Revlimid for non-FDA approved uses.
[15] According to Federal Bureau of Prisons, Perwaiz is currently incarcerated at FCI Cumberland Camp and his release date is February 16, 2070.
If, however, they want to ensure the government actively investigates the alleged fraud, they are encouraged to contact legal counsel from an experienced firm that specializes in qui tam litigation under the False Claims Act.
A good legal team can advise potential whistleblowers of their rights, protections, and what evidence is necessary to solidify a case against the group leading the fraud.