Imagine discovering a physician billing patients for unnecessary services or a prominent Connecticut health system leader engaging in kickback schemes. Fraudulent activities in trusted state health systems, hospitals, private practices, and pharmacies are serious money-making schemes that defraud the government and hurt the American people.
The Connecticut False Claims Act (or Connecticut whistleblower law) is a statute based on the federal False Claims Act, and it allows employees or other people to file a qui tam suit if they have knowledge a person or company knowingly submitted false claims to Medicaid and other Connecticut health and human services programs. The state-level law also incentivizes whistleblowers with compensation and offers job retaliation protection.
States like Connecticut are limited to healthcare fraud claims, while others are more general and include many types of fraud against the state. The False Claims Act is the government’s most powerful weapon for combating waste, fraud, and abuse at both federal and state levels.
Tycko & Zavareei LLP’s qui tam attorneys represent whistleblowers and fight fraud, abuse, and waste. We can help shed light on the Connecticut and federal False Claims Acts, whistleblower protections and rewards, and lawsuit requirements for potential whistleblowers considering reporting fraud.
Federal False Claims Act
The False Claims Act is a federal whistleblower law allowing private citizens to sue any person, company, or other entity responsible for defrauding the federal government. Violations might include billing for services not rendered, submitting inaccurate claims for services, accepting kickbacks, double billing, and more. There are two common elements a qui tam whistleblower must establish with the help of an attorney to prove a violation:
- A claim must be made knowingly
- A claim must be false or fraudulent
The defendant—a health system, physician, or pharmacy, for example—may be held liable upon demonstration that they intentionally submitted a false claim. Whistleblowers play a key role in bringing these bad actors to justice.
States model their whistleblower laws after the False Claims Act, and 30 states have a False Claims Act, including Connecticut, that empowers whistleblowers to initiate a qui tam action and seek recovery of a portion of a judgment.
Connecticut False Claims Act
The Connecticut False Claims Act is a state-level statute based on the Federal False Claims Act. It requires whistleblowers to use lawyers to file qui tam lawsuits if they know a person or company submitted false claims to Medicaid or other Connecticut health and human services programs. Generally, anyone with information involving corruption, unethical business practices, violations of state laws or regulations, mismanagement or gross waste of funds, abuse of authority, or danger to public safety within state medical assistance programs can report another party under the Connecticut False Claims Act.
The state adopted the Connecticut False Claims Act in 2009, and only cases involving healthcare fraud and false claims against state medical assistance programs qualify, including false records to obtain payment and conspiracy to violate the Act. It provides liability similar to federal law by imposing damages against defendants who violate the Act with civil fines of $5,500 to $11,000 per violation.
The people of Connecticut, whether an employee of the company that committed fraud, a client, or another person, are protected by and incentivized through state and federal whistleblower laws to pursue justice.
Connecticut False Claims Act Protections Against Job Retaliation
Whistleblowers help put a stop to illegal activities, recoup significant amounts of money, and sometimes save lives when they expose ill-willed behavior. While good for the government and people everywhere, some companies treat it as disloyal and try to punish employees.
The Connecticut False Claims Act protects whistleblowers who suffer from workplace retaliation after filing a complaint. Employees are protected from being discharged, demoted, suspended, threatened, harassed, and discriminated against in the terms and conditions of employment. If bias happens, employees are entitled to “all relief necessary to make the employee whole again,” including reinstatement with seniority, double back pay, interest on back pay, compensation for discriminatory treatment, reasonable attorneys’ fees, and other litigation costs.
If there is any question about whether a whistleblower is experiencing workplace retaliation, a strong case must show: the employer knew the employee (or whistleblower) was engaging in protected action under the False Claims Act—such as reporting fraud—and was fired, demoted, or otherwise punished for their actions. Furthermore, Connecticut requires that whistleblowers report discrimination within 90 days of their knowledge of the act occurring.
Anyone, for that matter, who investigates and provides testimony and assistance in a CT False Claims Act case is also protected from whistleblower retaliation.
Connecticut Whistleblower FAQs
What Rewards Can Connecticut Whistleblowers Receive?
Through a qui tam lawsuit, whistleblowers may be financially rewarded based on a percentage of the money recovered by the government through claims made under the SEC, CFTC, or IRS whistleblower programs.
Whistleblower rewards might be 15 to 25 percent of any proceeds from the action or settlement if a Connecticut whistleblower lawyer assists and 25 to 30 percent of the Connecticut Attorney General declines to join the lawsuit. Rewards may be reduced if the whistleblower’s qui tam complaint is based upon publicly disclosed information or if the whistleblower planned and initiated the fraud.
Here’s a recent example: A former employee of Northeast Medical in Connecticut received a payment of $106,536 in May 2023 as part of a qui tam lawsuit and settlement. The whistleblower helped the state and federal government recover $560,000 from Yale New Haven Health Services Corp. and Northeast Medical Group for their participation in submitting false Medicare and Medicaid claims for services billed by physicians and mid-level providers.
What is the Time Limit to File a CT False Claims Act Claim?
The Connecticut False Claims Act requires whistleblowers to file a qui tam claim within six years of reporting violations. Certain cases allow for an extension, such as ten years. A qui tam lawyer can play a crucial role in fighting fraud as they can offer legal advice regarding whistleblower laws and protection and can give your lawsuit a better chance of resulting in a settlement.
How Long Do Whistleblower Cases Take?
As a general estimate, it can take several months for a qui tam attorney to gather appropriate evidence and file a complaint. In contrast, a government investigation can take one to two years. More complex cases involving multiple government parties can take up to 10 years. No one qui tam case is the same, and timing will depend on a variety of factors.
Connecticut Whistleblower Claims and Legal Support
The Connecticut False Claims Act offers protection and possible financial incentives for whistleblowers who speak out for the greater good. Exposing fraud is not an easy decision, but neither is staying silent.
There is no simple healthcare fraud case, as the process takes time and usually involves many moving pieces and complicated circumstances. For this reason, False Claims Act cases initiated by private whistleblowers with experienced qui tam legal counsel are often more effective in combating fraud and recovering compensation.
Key factors to a successful whistleblower case involve thorough state and federal Fair Claims Act knowledge, strong evidence of illegal misconduct/negligence, among other things.
Tycko & Zavareei LLP specializes in federal and state whistleblower laws and can advise on related matters during a free case evaluation.
