Signs indicating a fraudulent billing practice often manifest in subtle patterns. Employees may become suspicious when they notice irregularities in Medicare billing procedures, discrepancies in government contractor documentation, lack of transparency in response to questions or feedback, or pressure to code procedures in a certain way to maximize reimbursement.
Some employers also maintain a culture of disregard for compliance with billing regulations. When management prioritizes revenue generation over ethical billing practices, employees may feel pressured to engage in fraudulent activities or look the other way. This pressure can be subtle, conveyed through performance metrics or implicit directives to meet financial targets.
When fraud is occurring at a company, it’s often considered “profitable.” Accordingly, internal reports of suspected fraudulent billing may go unaddressed or be dismissed by supervisors or administrators, fostering a sense of futility among employees attempting to raise concerns. Many whistleblowers opt to contact an outside attorney to protect themselves from potential retaliation and navigate the complex legal process involved in reporting fraud through a qui tam lawsuit.