Once you determine to your satisfaction that there is a possibility or probability of healthcare fraud, there are many options that present themselves to you. Should you report it internally? Should you report it to some sort of regulatory body in that area of the country, whether state or federal? You may choose to approach the attorney general of your state or otherwise report ethics violations in some other way.
According to the US Department of Health and Human Services, the False Claims Act is unique in the protections that it offers and the incentives that it offers. You cannot trust, in most circumstances, the internal reporting mechanisms or other regulatory bodies to protect you as a whistleblower. In worse circumstances, you may be inviting retaliation against you. The False Claims Act offers certain protections to whistle blowers that are important for any potential healthcare fraud whistleblower to consider.
The important thing to do in the circumstances for a whistleblower is to talk to a health care fraud attorney experienced with the False Claims Act. The reason for this is that if you take other routes first, you may be limiting your ability to protect yourself, in addition to limiting your ability to be rewarded for the risk you are taking as a whistleblower.
Once you start a conversation with someone under the False Claims Act, you are not giving up the ability to pursue those other avenues. But you will be looking at those other options with more information, and you will be able to look at the whole picture and weigh the pros and cons of your options.