FALSE CLAIMS ACT

Mr. Feldman is a False Claims Act attorney.  The False Claims Act permits the government or a “relator” (whistleblower) to bring a lawsuit against a person or organization that has presented a claim to the U.S. government for property or money when that claim is false or fraudulent. Prosecutions may therefore occur when the Government spends money for national defense, health care, transportation, infrastructure, banking, or to acquire goods or services, chances are the Government will also closely monitor that organization or person receiving those federal dollars.

Prosecutions are particularly common in the context of health care. The Government, through Department of Justice Civil and Criminal Divisions, has collected millions, if not billions, of dollars by using the False Claims Act against health care providers – doctors, nursing homes, assisted living facilities, medical device companies, pharmaceutical companies, radiologist groups, laboratories, cardiovascular testing facilities, dermatologists, cardiologists, podiatrists, and ophthalmologists.

The False Claims Act, 31 U.S.C. §3729 et. seq., is an extraordinarily powerful weapon that the Government continues to use to fight health care fraud and abuse. False Claims actions unlike indictments or criminal prosecutions for health care fraud or violations of the Anti-Kickback Statute are civil not criminal actions. Nonetheless, the Civil and Criminal Divisions of the Department of Justice work closely together in this context and there are occasions when the Government has brought an action against a provider and then, later on, indicted that same provider in a criminal case. While this is not the rule in each case, a person seeking guidance in this area should be well positioned to navigate these types of parallel proceedings. Civil and criminal investigations are distinct and the discovery rules and mechanisms for gathering evidence are different.

Actions are also generally brought by whistleblowers who are eligible to share in the recovery of the total settlement or judgment. However, the Government, on its own, can decide to bring an action against a health care provider or organization based on evidence of health care fraud and abuse. Once the whistle blower brings a lawsuit (also known as a qui tam) the Government will investigate the claims while the lawsuit remains under seal. The Government investigates these claims by, among other things, sending civil investigative demands to persons or companies whom may be able to corroborate or add value to the allegations in the lawsuit. At a certain point, the Government then decides whether to intervene in the lawsuit. If it does, then, statistically, the chances that the False Claims Act action may be successful are higher than they otherwise might be.

A False Claims Act attorney can assist health care professionals and government contractors ensnared in a government investigation. Among other things, a False Claims Act attorney may assist with the following:

  • Responding to civil, criminal, and administrative investigative subpoenas
  • Civil Investigative Demands (or “CIDs”)
  • False Claims Act litigation – including federally initiated and qui tamactions – throughout the country
  • Grand jury investigations
  • Search warrants
  • Suspension and debarment proceedings

Hiring a False Claims Act attorney is an important decision. When a possible violation of the False Claims Act is detected in advance of any Government investigation or lawsuit, the Firm is well positioned to counsel providers on possible voluntary disclosure, to take corrective or curative steps to remediate the problem through a comprehensive internal investigation, or to formulate or revise a compliance program, including providing training to the particular organization.