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Dec 30, 2020 by |

California and San Francisco Whistleblower Attorney: Fraudulent Medi-Cal Billing


Billing For Services Never Provided

Medi-Cal Fraud In Substance Abuse Programs

Rewards For Bringing Fraud To Light

Fraud against Medi-Cal is a crime and also a false claim against the State of California exposing the wrongdoer to actions for civil damages and penalties. Cal. Gov’t Code §§ 12650 et seq. Individuals can institute civil actions against businesses defrauding the State by bringing cases under the California False Claims Act, Cal. Gov’t Code §§ 12650 et seq.  If the State of California recovers money from the defrauding business, the whistleblower (known under the statute as a “qui tam plaintiff”) is entitled to a reward of a substantial percentage of the funds recovered.  The litigators at Evans Law Firm, Inc. represent qui tam plaintiffs in all sorts of cases of fraud against the State of California, including for Medi-Cal fraud.  If you have credible information of fraud against the government, call the whistleblower attorneys at Evans Law Firm today at (415)441-8669 and we can help.

Medi-Cal Fraud Case

One recent example of a Medi-Cal fraud case occurred in Southern California[1] where a substance abuse counseling center was accused of fraudulently submitting more than $500,000 in claims for services that did not qualify for reimbursement under Medi-Cal or were never provided.  According to allegations in the case, defendants submitted false and fraudulent bills for counseling sessions that were not conducted at all, were not conducted at authorized locations, or did not comply with Drug Medi-Cal regulations regarding the length of sessions or the number of clients.  The complaint also alleged that the owner of the facility caused the center’s staff to bill for clients who did not have a substance abuse problem, to falsify documents related to services supposedly provided to clients, and to forge client signatures on documents such as sign-in sheets.  The owner and director of the center are being criminally prosecuted for the alleged fraud.

Whistleblowers Can Be Rewarded

Individuals with information of this type of Medi-Cal fraud can be rewarded for bringing a suit under the California False Claims Act (“CFCA”), Cal. Gov’t Code §§ 12650 et seq., on behalf of the State of California against all persons responsible for defrauding the State.  The case begins by filing a sealed complaint in the Superior Court of California and serving a copy of the complaint and a statement regarding the material evidence supporting the complaint with the State Attorney general.  Cal. Gov’t Code § 12652.  If the State recovers from the wrongdoers, the plaintiff (or qui tam relator) is entitled to a reward.  Cal. Gov’t Code § 12652(g).  Employers are prohibited from retaliating against employees for blowing the whistle on fraud against the State and the Evans Law Firm whistleblower attorneys can represent you in any action against your employer for wrongful termination.  Remedies include reinstatement, double back pay, and an award of attorneys’ fees and expenses.  Cal. Gov’t Code § 12653.

Contact Us

If you have credible information of Medi-Cal fraud, contact Ingrid M. Evans and the other California whistleblower and false claims attorneys at Evans Law Firm at (415) 441-8669, or by email at <a href=””></a>. In addition to California False Claims Act cases, Ingrid and our other whistleblower attorneys handle cases involving false claims against the federal government (as with Medicare and other federal health programs), bank fraud under FIRREA/FIAFEA, the Commodities Futures Trading Commission Whistleblower Program, the Securities and Exchange Commission Whistleblower Program, the FINRA Whistleblower Office and the Internal Revenue Service Whistleblower Office. 

[1] Evans Law Firm, Inc. was not involved in the case in any way.

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