ATTORNEY NEWSLETTER
Alleged Violations Of Terms For Government Payments
False Certifications Of Eligibility Alleged
$8.3 Million Reward For Two Whistleblowers
Government payments to businesses whether for work performed under government contracts or for services provided under government programs like Medicare and Medicaid invariably has certain eligibility and performance requirements and certifications to be met before funds can be released. Whenever a business knowingly submits a claim for payment where the requirements have not been satisfied, fraud occurs. Any individual with knowledge of such fraud against the government is authorized to bring an action on behalf of the government to recover money paid out on fraudulent claims. See False Claims Act (FCA), 31 U.S.C. §§ 3729 et seq. These cases are known as “qui tams” and the plaintiffs are referred to as “relators.” Relators can be rewarded 15-30% of the amounts and penalties recovered. 31 U.S.C. § 3730(d). Every year private individuals recoup more money for the government lost to fraud than the government itself does. Last year alone, of the $2.1 billion recovered by the government from wrongdoers, over 80% came from actions brought by private individuals against those businesses perpetrating the fraud. The majority of the fraud is perpetrated in the health care field. Evans Law Firm, Inc. represents individuals in bringing qui tam actions against those who defraud the government in LSan Francisco and throughout California, call us today at (415)441-8669 and we can help. Our toll-free number is 1-888-50EVANS (888-503-8267).
Recent Settlement Of Healthcare Fraud Allegations[1]
In a recent settlement announced by the U.S. Department of Justice (DOJ), two related cardiac monitoring companies have agreed to pay $44,875,000 to resolve allegations that they violated the False Claims Act by knowingly submitting claims to Medicare, TRICARE, the Veterans Health Administration, and the Federal Employee Health Benefits Program for heart monitoring tests that were performed, in part, outside the United States, and in many cases by technicians who were not qualified to perform such tests.
Specifically, the government alleged that the defendants improperly billed Medicare and other federal health care programs for certain cardiac monitoring services that were performed overseas in violation of federal law that prohibits payment for services furnished outside the United States. The government alleged that defendants contracted with offshore companies to provide diagnostic and analysis services and then routed the data to a domestic independent diagnostic testing facility for review and analysis, and then re-routed certain data offshore for analysis when the domestic workflow became backlogged. The outsourcing of the data analysis contravened federal regulations according to the DOJ.
How A Qui Tam Case Begins
A qui tam cases begin with filing a sealed (non-public) complaint under the FCA in the federal district court where the allegedly fraudulent conduct occurred. 31 U.S.C. § 3730(b). The government has sixty days to review the allegations and decide whether to intervene in the case. This review period can be extended, and often times is, for a year or more as the government continues to investigate the allegations. If the government decides to intervene, the government essentially takes over the litigation. 31 U.S.C. § 3730(c). If the government decides not to intervene, the relator has the right to continue the litigation on his or her own. If the relator continues the litigation alone, he or she receive a larger percentage of the amount the government eventually recovers. 31 U.S.C. § 3730(d). The relator may also pursue claims for wrongful retaliation against the defendant if the relator were fired or demoted as a result of blowing the whistle. 31 U.S.C. § 3730(h).
Contact Us
If you have credible information of healthcare fraud against the government here in San Francisco or elsewhere in California, call Ingrid M. Evans at (415) 441-8669, or toll-free at 1-888-50EVANS (888-503-8267) or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>. In addition to FCA whistleblower cases, Ingrid also handles 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. is not involved in the case in any way.
