ATTORNEY NEWSLETTER
Alleged False Claims For Uninsured Medical Testing And Treatments
Patient Blew Whistle On False Claims
Whistleblower To Receive Over $2M As Reward
Private citizens bring cases in federal courts throughout the country under the False Claims Act, (“FCA”), 31 U.S.C. § 3729 et seq, to help the government recoup funds paid out on fraudulent claims. Each year, citizens recover billions of dollars for the government (and by extension, all of us) through these cases. If the government recovers, the whistleblowers are rewarded. 31 U.S.C. § 3730(d). The whistleblowers bringing the cases are referred to under the FCA statute as “relators,” and the cases themselves are called “qui tam” cases. Relators of fraudulent conduct are often employees or managers, or former employees or managers, or (in healthcare cases) patients of the business engaging in the fraud. Much fraud occurs in the healthcare field and false claims to the government are often accompanied by other infractions such as illegal kickbacks for medical referrals prohibited by the Anti-Kickback Statute and Stark Law. 42 U.S.C. § 1320a-7b (Anti-Kickback Statute); 42 U.S.C. § 1395nn (Stark Law). If you have credible information of fraud against the government in violation of the FCA in San Francisco or elsewhere in 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[1]
The US Department of Justice (DOJ) recently announced that a large group of urgent care practices in New Jersey and New York, have agreed to pay $12,037,109 to resolve allegations that they violated the False Claims Act by submitting or causing the submission of false claims for payment for COVID-19 testing to a Health Resources and Services Administration (HRSA) program for uninsured patients. Under the HRSA’s uninsured patient program, health care providers are reimbursed for tests and vaccinations for certain uninsured patients.
The Justice Department alleges that the defendants knowingly submitted or caused to be submitted false claims for payment for testing to the Uninsured Program for individuals who actually had health insurance coverage. The United States further contends that defendants caused outside laboratories to submit false claims for testing to the Uninsured Program in connection with individuals who had health insurance coverage by issuing requisition forms erroneously indicating that patients were uninsured.
“The Uninsured Program provided critical financial support for COVID-19 related testing and treatment for uninsured Americans during the height of the pandemic,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “Today’s settlement reflects the department’s commitment to ensuring that the pandemic relief programs created by Congress were used as intended.”
Starting A Qui Tam Action
Any False Claims Act whistleblower case begins by a relator filing a complaint under seal in the federal court usually for the United States District Court for the district where defendant is located or does business. At the same time, the relator submits a disclosure to the DOJ outlining the material evidence the relator has of the alleged false claims. 31 U.S.C. § 3730(b). The seal period of the complaint lasts 60 days during which the DOJ investigates the claims. 31 U.S.C. § 3730(b)(2). (If necessary, the government can, and often does, extend the 60-day period during which the allegations are kept under seal.) If the government decides to intervene in the case, the government essentially takes over the litigation. 31 U.S.C. § 3730(c)(1). If the government declines to intervene, the relator may proceed with the litigation on his or her own. 31 U.S.C. § 3730(c)(3).
Contact Us
If you have credible information of government fraud 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 and CFCA whistleblower cases, Ingrid and Evans Law Firm, Inc. 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.
