We hear about lawsuits and false claims acts regularly, but did you know that many of these begin with someone working from inside the organization? Calling out bad behavior or noncompliance, sometimes again and again without being heard—before deciding to call on a third party for help?

You might have seen the recent headlines about New York insurer Independent Health, which agreed in December to pay $100M to settle allegations it had upcoded claims to inflate Medicare Advantage payment. But did you know the basis of the lawsuit was a whistleblower, and 12 years in the making?

My guest on Off the Record knows this very well. Mary Inman is a Partner at Whistleblower Partners LLP, and Head of International Whistleblower Practice for the firm. She also served as legal counsel in this very case.

I continue my “law and coding” start to 2025 with a fascinating guest and topic. On this show we discuss:

Who/what is a whistleblower, and the concept of qui tam

The mechanics/process of a whistleblower engaging a lawfirm: Are they working for their employer throughout reporting, discovery? Is gathering evidence to support their case without employer knowledge illegal?

What happens to a whistleblower who wins—or loses? How much can they stand to make, and is their career over?

New DOJ whistleblower project to encourage additional reporting

What some whistleblowers get wrong/false report or misunderstand

What hospitals/healthcare organizations can do to lessen the risk

Mary’s Off the Record Spotify playlist selection (I was disappointed it was not Judas Priest’s Breaking the Law)