Medicare Compliance & Reimbursement

82% of whistleblowers in NEJM study were subjected to pressures by their company.

When Congress passed the healthcare bill in March 2010, everyone said that there was an even greater need for whistleblowers to identify fraud in the healthcare industry. But with the passage of a few months now, it looks like these whistleblowers are getting a raw deal.

A blog post on www.quitamteam.com mentions a New England Journal of Medicine (NEJM) study entitled, "Whistle-blowers' experiences in fraud litigation against pharmaceutical companies." The study, it says, confirms what was already common knowledge: whistleblowers who report healthcare fraud receive little support and experience substantial stress. The findings of this study appear to confirm what other studies have revealed in the past, that pharmaceutical whistleblowers "just don't get any respect."

In the NEJM study, the experiences of 42 pharmaceutical whistleblowers were examined and all but six of the relators in the study did not specifically intend to use the qui tam mechanism when they decided to seek legal redress for the frauds they observed. Contrary to common perception, monetary reward was not what drove these whistleblowers. Rather, they were driven by integrity, altruism or public safety, justice, and self-preservation.

The NEJM study says most whistleblowers shared certain common experiences in exposing fraud. They became active participants in the investigation, such as by wearing a wire.  They also reported spending inordinate amounts of time working on the investigation, sometimes meeting with FBI agents in risky locations or being forced to devise hasty covers for agents visiting the whistleblower's workplace on short notice. Many relators were frustrated with the government at various points during the investigation.

Another common factor among them was the personal toll. Most of these whistleblowers reported financial difficulties. Not just that, some also experienced divorce or other family problems. In addition to that, whistleblowing took a physical toll also, with several study particpants reporting health problems ranging from asthma to migraines.

In spite of all this, when it was all over, most of the relators felt that what they did was important for ethical or psychological reasons despite dissatisfaction with the financial reward. Notably, the advice offered to potential whistleblowers by some of these seasoned, war-weary whistleblowers was to hire an experienced attorney.

(Editor's note: Read the complete NEJM study at: http://www.nejm.org/doi/full/10.1056/NEJMsr0912039, and the blog post at: http://quitamteam.com/blog/category/pharmaceutical/page/2/.)