• Apr
    21
    Posted in:
    Posted by: Jarve Kaplan Granato Starr

    What Actions Are Considered Violations under the False Claims Act?

    The False Claims Act is a federal law that helps the government of the United States to fight fraud with the help of American citizens. When people become aware of fraud being perpetrated by their employer or a company with whom they are doing business, they are able to become “whistleblowers” and file a lawsuit in their own name on behalf of the government. This is known as qui tam litigation. If these lawsuits are successful, the person who acted as a whistleblower is entitled to up to three times the damages that the government incurred, as well as between 15 and 30 percent of recoveries in the case.  The U.S. False Claims Act originated with Abraham Lincoln, who enacted it in order to stop defense contractors from cheating the government during the Civil War. Since that time it has been used against a variety of companies, but in recent years the majority of whistleblower cases have involved fraud in Medicare and Medicaid. Getting involved in qui tam litigation is an extremely complex process, and it is strongly advised that if you are aware of fraud against the government, you seek the help of an experienced qui tam litigation attorney.

     

    Many people who work in healthcare, defense contracting, and other industries that are vulnerable to government fraud suspect that something illegal is going on, but are not entirely sure of what constitutes fraud. There are several different actions that a company can engage in that would be considered violations under the False Claims Act, including:

     

    • Billing for goods and services that were not delivered or made
    • Billing more than once for the same service or materials
    • Billing the government for non-contract related functions, including lobbying or marketing
    • Providing fraudulent receipts or service records
    • Providing samples that are better than the product that is being provided
    • Providing defective or untested equipment or materials
    • Shifting expenses from one contract to another
    • Marketing medical devices or prescription drugs through kickbacks to providers
    • Billing for drugs or devices that do not have FDA approval
    • Increasing bills to Medicare for reimbursement by providing unnecessary or inappropriate medical procedures
    • Billing Medicare or Medicaid for medical services or laboratory tests that have not been provided
    • Winning a contract through kickbacks and bribes
    • Failing to report known product defects in order to be able to continue to sell or ill the government for the product
    • Billing in order to increase revenue instead of to reflect work that was actually performed
    • Failing to report an overpayment by the government
    • Billing for brand-named drugs while actually providing generic drugs
    • Charging for services provided by employees that were not actually on the job or for hours of work that were not actually provided
    • Forging physician signatures when real signatures are required for reimbursement

     

    There are a number of restrictions in how a civil qui tam litigation case is to be filed, and the extent of the fraud that warrants filing a claim. There are also rules that limit the number of claimants to just one whistleblower. For more information, we urge you to contact Jarve, Kaplan, Granato & Starr LLC at your earliest convenience.

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