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Feb 17, 2016 by |

San Francisco Qui Tam Attorney: False Claims Act


Health Care Providers seek to weaken False Claims Act

Healthcare is one of the areas most frequently involved in qui tam cases, and by restricting the avenues available for prosecutors to pursue claims against nursing homes, health care facilities, and pharmaceutical companies, lobbyists hope to prevent the government recouping as much through False Claims Act cases, and to prevent as many cases from being brought. In 2015, the government recovered billions of dollars lost through healthcare fraud, which represents a considerable blow to the industry.

The False Claims Act is a law dating back to the Civil War, designed to allow private citizens to bring suits against companies or individuals defrauding the federal government. In exchange, they are given a percentage of the recovered funds, and in certain cases, the governments legal office may take over the case on behalf of the relator.

In recent years, this type of case has most commonly been used to combat fraud in the healthcare sector, since the Medicare and Medicaid account for some of the largest government expenses. The sheer quantity of funds may incentivize providers to try to skim some extra money off the top, using means such as providing unnecessary services or procedures, putting patients into care levels they do not require, billing for time that was not actually spent looking after the patient. Or providing lower-quality products or care than is billed for.

Not only do these kinds of practices divert funds from the government, but they also result in harm to seniors, the chronically ill, and others who would benefit the most from a high standard of care. Relators, by bringing these harmful practices to light, help raise the bar for health care providers, and unveil misdeeds that would otherwise be concealed from the public. By trying to limit and restrict the investigation into internal practices that occurs after a qui tam suit is brought, health care providers are hoping to limit the damage done to their bottom line by their own actions.

If you are aware of fraud being carried out by a healthcare provider, pharmaceutical company, or any other organization that is receiving federal funds, please contact the Evans Law Firm at (415) 441-8669, or by email at We handle healthcare, insurance, and banking fraud, as well as financial and physical elder abuse, qui tam and whistleblower law, and nursing home abuse cases.

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