ATTORNEY NEWSLETTER
Allegations of False Marketing Tactics
Unapproved Systems For Pediatric Care
Case Brought By Employees
False claims for reimbursement under government-sponsored health care programs may violate both federal law (when the claims are submitted to Medicare and other federal programs) and State law (when the claims are submitted to Medi-Cal and other California programs). See federal False Claims Act (FCA), 31 U.S.C. §§ 3729 et seq. and California False Claims Act (CFCA), Cal. Gov’t Code § 12650 et seq. Cases under the FCA and CFCA are brought by individuals referred to as whistleblowers or “relators” under both statutes. Individuals with knowledge of fraud (as in the use of substandard or non-compliant materials or goods) bring their cases (known as qui tams) by filing a complaint under seal and providing a copy of the complaint and a statement regarding their evidence to the government for evaluation. 31 U.S.C. § 3730(b)(federal); Cal. Gov’t Code § 12652(c)(1)(California). Possible plaintiffs include current or former executives, current or former employees, or accountants, agents, or consultants may be the individuals with firsthand knowledge of the fraud and the plaintiffs (also called “relators) in these qui tam actions. If you have credible information for a false claims whistleblower case or any other whistleblower case in Los Angeles or elsewhere in California, call us today at (415)441-8669 and we can help.
Allegations of Charging Federal and State Governments for Unapproved Procedures
In one recently settled case, [1]a medical services producer has agreed to a $10 million payment to settle allegations that the producer engaged in improper marketing tactics and submitted false claims to Medi-Cal. The case specifically alleged that the company improperly marketed prescription medical device systems to doctors for use in pediatric patients despite the systems not being approved by the U.S. Food and Drug Administration (FDA) for pediatric use. Two employees of the defendant brought a CFCA complaint alleged the maker used significant marketing tactics to persuade doctors to prescribe the maker’s systems as an off-label, or unapproved, treatment of graft-versus host-disease (GvHD) in both adults and children. The FDA never approved the use of the systems on pediatric patients, however, contrary to the manufacturer’s claims. The settlement was negotiated by the California Department of Justice’s Division of Medi-Cal Fraud and Elder Abuse (DMFEA), working with a team of other states and the federal government. Through the DMFEA, the California Attorney General protects Californians by investigating and prosecuting those who perpetuate fraud on the Medi-Cal program. DMFEA also investigates and prosecutes those responsible for abuse, neglect, and fraud committed against elderly and dependent adults in the state. DMFEA regularly works with whistleblowers, the California Department of Health Care Services, and law enforcement agencies to investigate and prosecute.
Blowing The Whistle On Government Fraud
Cases such as the reported case are often brought by current or former employees and other insiders. If the individual with information of the fraud is a currently employed individual, the employee/relator is protected from employer retaliation for bringing a qui tam case. 31 U.S.C. § 3730(h)(federal anti-retaliation protection); Cal. Gov’t Code § 12653 (State anti-retaliation protection). If you are fired because you brought any fraud to light, you can fight back under the law. You may be entitled to sue your employer and seek double back pay (with interest), reinstatement, reasonable attorneys’ fees, and reimbursement for certain costs in connection with the litigation. 31 U.S.C. § 3730(h)(2). Our Los Angeles whistleblower attorneys can represent you in any action for retaliation as well as represent you in your underlying whistleblower application. We know how to investigate and litigate retaliation cases with the aim of obtaining our clients all relief available under all governing laws.
Contact Us
Ingrid M. Evans and our other Los Angeles whistleblower attorneys represent individuals with information of fraud against Medicare and Medi-Cal, and other federal and State government programs. If you have the basis for a false claims act case, you can reach Ingrid at (415) 441-8669, or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>. Our attorneys also handle bank fraud whistleblower cases under FIRREA/FIAFEA, commodity trading and securities fraud under the Commodities Futures Trading Commission Whistleblower Program and the Securities and Exchange Commission Whistleblower Program, and tax fraud under the Internal Revenue Service Whistleblower Program.
[1] Evans Law Firm, Inc. was not involved in the case in any way.
