False Claims Act

Recent Overview of the False Claims Act

Published on: April 16, 2024 | By Conaway & Strickler, P.C.

Settlements and judgments under the False Claims Act have reached a unprecedented high in the United States. According to the Department of Justice in a press release, there were 543 settlements and judgments in the 2023 fiscal year, which exceeded over $2.68 billion. In the release, Principal Deputy Assistant Attorney General Boynton states “As the record-breaking number of recoveries reflects, those who seek to defraud the government will pay a high price.”

The False Claims Act (FCA), also known as the “Lincoln Law,” is a federal law that imposes liability on individuals and companies who defraud governmental programs. This includes submitting false invoices, making false statements to get paid by the government, or avoiding payment of money owed to the government. The law was originally enacted during the Civil War to combat fraud by government contractors supplying the Union Army with substandard goods; however, the FCA was strengthened in 1986, when Congress increased incentives for whistleblowers to file lawsuits alleging false claims on behalf of the government.

Under the FCA, individuals or entities can be held liable for knowingly submitting false or fraudulent claims for payment to the government. The FCA allows private individuals, known as “whistleblowers” or “relators,” to file lawsuits on behalf of the government and share in any monetary recovery. These lawsuits are known as qui tam actions. If the government intervenes in the lawsuit and recovers funds, the whistleblower is typically entitled to receive a portion of the recovered amount, often ranging from 15% to 30%. In fiscal year 2023, whistleblowers filed 712 qui tam suits, and this past year the Justice Department reported settlements and judgments exceeding $2.3 billion in these and earlier-filed suits.

What are the current DOJ priorities?

Published on: April 1, 2022 | By Conaway & Strickler, P.C.

Attorney General Merrick Garland made recent comments about what he considered to be the Department of Justice’s top priorities for 2022. Since taking office in March 2021, Garland has tried to combat crime in a tumultuous time. He has been criticized for his handling of January 6 investigation and has stated it’s the most urgent probe in history.

With all of this going on, the US Attorney’s office increased its prosecutions of individuals of white collar crimes in the year 2021. White collar charges like fraud, theft, corruption, bribery, environmental crime, tax fraud, health care fraud, procurement fraud, money laundering, PPP loan fraud, etc will continue to get more attention from the Department of Justice.

What does this mean? It means that investigations of any sort need to be taken seriously and that you should contact a lawyer immediately if any wrongdoing is alleged.

Whistleblower / Qui Tam cases in Health Care

Published on: September 11, 2021 | By Conaway & Strickler, P.C.

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Health Care Qui Tam cases

What does Qui Tam mean?

Qui tam is short for the Latin phrase “qui tam pro domino rege quam pro se ipso in hac parte sequitur,” which roughly translates to “he who brings an action for the king as well as for himself.”

False Claims Act – How to Defend Against the Government

Published on: April 26, 2016 | By Conaway & Strickler, P.C.

False Claims Act – Has the state or federal government reached out to your professional office alleging violations of the False Claims Act? Call Conaway & Strickler, PC as soon as possible if so. It is imperative to have help at the first indication that the government is looking into your billing for Medicare. Are they alleging upcoding? Overbilling? Phantom billing? The U.S. Attorney’s Office and /or the State will attempt to sue you under the False Claims Act, but also, will attempt to bring criminal charges. They may be alleging that some billing was not done in compliance with Medicare rules. Having a lawyer involved will help throughout the process and can dramatically reduce the amount the government alleges were wrongfully billed.

Physicians and practice groups that have either received a letter or a “knock and talk” from the government should not attempt to deal with the allegations of improper billing without legal help. We can help you show the government that the all costs billed to Medicare were for services provided and that no costs were inflated. We can also enter into negotiations to settle claims of violations of the False Claims Act with the Department of Health and Human Services and the Officer of the Inspector General.

The government has worked hard in recent years in combating health care fraud under the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced by the Secretary of the Department of Health and Human Services in May 2009. And one of the most powerful tools in the government’s arsenal is the False Claims Act.