How to Report Fraud

Fraud is when one party lies or misrepresents information to another party to deprive them of funds or property. Intent differentiates fraud from a misunderstanding.

Examples of fraud include:

• Falsification of billing records
• Health insurance scams
• Misuse of government grants or contract funds
• Tax evasion and refund abuse

Reporting fraud can be complicated, especially if it involves crimes committed across state lines or by mail or electronic communications.

Keep reading to learn about reporting fraud to the proper federal or state agencies.

Before reporting potential fraud as a whistleblower, be sure to gather some key information. This will help authorities decide whether to take action and what protections you’re entitled to.

First, make a list of everyone involved, including their names, position and contact information. Include the names of any organizations involved.

Next, explain what happened. This step is essential. Consider making a timeline that outlines suspicious actions. Explain why these events are important.

Third, collect evidence. Emails, billing information, contracts and other documents can be important assets for investigators. Investigating agencies may prefer this information in electronic formats.

While working with an attorney isn’t always required, one can help you identify what’s important for the report and help you file your claim.

Who can file a fraud report?

A person who witnessed the fraudulent activity can file a report. But whistleblowers can also have a representative, such as an attorney, file the report. Getting an attorney can help whistleblowers improve their fraud report or complaint, protect their anonymity, and shield them from retaliation.

Learn more about whistleblowers.

What happens with your information after you file a fraud report might vary by agency and by the type of fraud you’re reporting. For example, reporting that a manufacturer is mislabeling its products might be handled differently than a whistleblower reporting a government employee getting kickbacks from a contractor.

In general, a fraud complaint may follow the steps below.

1. Initial review: Federal or state agencies assess the credibility and seriousness of the complaint. If it warrants further investigation, the agency will assign an investigator and inform the whistleblower (complainant) and the accused party (respondent) that there’s an open investigation.
2. Investigation: The investigator will ask the complainant and respondent to provide copies of all documents they’ve submitted to the investigating agency. Both parties can respond to each other’s documentation.
3. Recommendation: The investigator will make recommendations, and the agency will decide whether to dismiss the claim or have the case heard in court.
4. Settlement or legal action: Some agencies, such as the Occupational Safety and Health Administration (OSHA), encourage parties to settle voluntarily. In some situations, the case may have to go before a judge, which could result in financial penalties or criminal charges.

Whistleblowers who experience retaliation after the conclusion of an investigation may file complaints. This can help resolve dismissals, demotions or other retaliatory actions.

Learn about different types of whistleblower cases.

Can I report fraud anonymously?

Yes, many agencies allow anonymous tips. However, your legal options may be limited if you don’t identify yourself. Before filing a whistleblower complaint, consider checking with the applicable agency. You can also consider retaining a whistleblower attorney.

What happens if the agency doesn’t act?

If the government declines to intervene, a whistleblower’s next action may depend on the agency they reported to. Some agencies may allow whistleblowers a certain time to request a review.

Will I get in trouble for reporting fraud?

Federal whistleblower laws prohibit retaliation. Employers could face serious consequences if you’re fired, demoted or harassed for speaking up. Disciplinary actions for retaliation could include being barred from federal employment, demotion, dismissal, fines and/or reprimands.

Can you be compensated for reporting fraud?

The U.S. government has strong laws for whistleblower compensation and protection. Many government agencies have programs to reward whistleblowers for reporting fraud. Depending on the type of fraud and the assistance provided, whistleblowers could be entitled to between 10% and 30% of the money the government recovers in a successful action.

How can a lawyer help with reporting fraud?

A whistleblower attorney can help you with reporting fraud in several ways, including protecting your identity, navigating the reporting process, gathering evidence and protecting you from retaliation.

Motley Rice attorneys have represented whistleblowers in cases involving fraud against companies and government agencies, including:

• Banks and financial services companies
• Government contractors
• Healthcare providers
• Major pharmaceutical companies
• Recipients of government grants, loans or financing
• Securities and commodities issuers and broker-dealers
• Tobacco companies

We’re committed to protecting the privacy and safety of those who report fraud. We can also help whistleblowers navigate the reporting and legal process.

Read more about our experience helping fight fraud against government agencies.