action allows for an employee to file a lawsuit against his or her employer if the employer is fraudulently billing the federal government. This action is called a qui tam lawsuit. If the government proceeds with the action and collects, the individual is eligible to receive 15-25% of the settlement or proceeds of the action. The amount, if any, is dependent on the extent the individual contributes to the prosecution of the action.
However, the court may reduce the whistleblower’s share of the proceeds if the court finds that the whistle blower planned and initiated the false claims violation. Further, if the whistleblower is convicted of criminal conduct related to his role in the preparation or submission of the false claims, the whistleblower will be dismissed from the civil action without receiving any portion of the proceeds.
Penalty
The penalty for making a false claim is a fine of no less than $5000 and not more than $10,000 plus three times the amount of damages to the government.
Notice to contractors and agents as required by section 6032 of the deficit reduction act of 2005
Consistent with Section 6032 of the Deficit Reduction Act of 2005, University Health System has established this notice to provide you with detailed information about the False Claims Act and the Health System’s own Integrity Standards to demonstrate our commitment to preventing and detecting errors, fraud, waste and abuse.
For purposes of Section 6032 of the Deficit Reduction Act, the Center for Medicare and Medicaid Services’ position is that contractors or agents must adopt the University Health System’s Integrity Standards and any other policies that prevent and detect errors and fraud. These policies can be found on the Integrity and Regulatory Services Website. CMS has defined “contractor or agent” as one which, or one who, on behalf of the University Health System, furnishes or otherwise authorizes the furnishing of Medicaid health care items or services, performs billing or coding functions, or is involved in monitoring health care.
These policies can be found on the Integrity and Regulatory Services Website.
However, our expectation is that ALL of our vendors will adopt the University Health System’s high ethical business standards as outlined in our Integrity Standards so they may continue their business relationship with us.
Those wishing to report a concern may call:
Integrity Officer
210-743-6540
Or email HIPAAOfficer@uhs-sa.com
Or anonymously @ The Integrity Hotline 1-877-225-7152
24/7