Whistleblower Protections and Reporting Mechanisms Flashcards
7 cards from real CHC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Whistleblower Protections and Reporting Mechanisms flashcards as text
Under the False Claims Act, what term describes a lawsuit filed by a private individual on behalf of the federal government to report fraud?
Answer: Qui tam action
A qui tam action allows a private individual (the relator) to sue on behalf of the federal government and share in any monetary recovery.
What percentage of the government's recovery can a qui tam relator typically receive when the government intervenes in a False Claims Act case?
Answer: 15–30%
When the government intervenes, the relator typically receives 15–30% of the recovery; the share is higher (25–30%) when the government does not intervene.
Which federal law contains the primary anti-retaliation provisions protecting healthcare employees who report fraud against government programs?
Answer: False Claims Act
The False Claims Act's anti-retaliation provision (31 U.S.C. § 3730(h)) protects employees who report or assist in investigations of fraud against the government.
Under the False Claims Act, what is the statute of limitations for filing a qui tam lawsuit?
Answer: 6 years from violation or 3 years after government knew, whichever is later (max 10 years)
FCA qui tam suits must be filed within 6 years of the violation or 3 years after the government knew or should have known, whichever is later, but no more than 10 years total.
What remedies does the False Claims Act provide to a whistleblower who was wrongfully terminated for protected reporting activity?
Answer: Reinstatement, double back pay, and attorneys' fees
The FCA provides reinstatement to the same seniority level, double back pay, and special damages including attorneys' fees for employees who suffer retaliation.
What is the 'first-to-file' rule under the False Claims Act?
Answer: Only the first qui tam complaint filed regarding a particular fraud scheme may proceed
The first-to-file rule bars later-filed qui tam suits based on the same underlying facts as a pending prior action, preventing duplicative litigation.
Which agency operates the primary federal hotline (1-800-HHS-TIPS) for reporting Medicare and Medicaid fraud?
Answer: Office of Inspector General (OIG)
The HHS Office of Inspector General operates the OIG Hotline to receive and triage reports of fraud, waste, and abuse in HHS programs including Medicare and Medicaid.