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Nov 23, 2020 by |

California San Francisco False Claims Act Whistleblower Attorney: Fraudulent Billing For Medicaid Dental Services

ATTORNEY NEWSLETTER

Fraudulent Billing Under Medicaid 

Dental Group Allegedly Billed For Work Never Performed

Reward For Individual Who Blew Whistle

False billing of the government for any work or services constitutes a violation of the False Claims Act (“FCA”).  Services paid for by the government include medical and dental services paid for under Medicare or Medicaid (known as Medi-Cal in California).  This kind of healthcare fraud costs the government – and taxpayers – billions of dollars every year.  Fortunately, the law rewards individuals who help the government recover money from those responsible. Our whistleblower attorneys represent individuals with credible information of fraud under Medicare or Medicaid and help them bring whistleblower (or, “qui tam”) actions for which they may be eligible for rewards if the government recovers funds.  If you have credible, original information of healthcare fraud, call Evans Law Firm, Inc. today at (415)441-8669 or toll-free at (888)-50EVANS (503-8267) and we can help.

A Case of Fraudulent Billing for Medicaid Dental Services

In one recently settled qui tam action,[1] a whistleblower alleged that a dental group billed Medicaid for dental fillings that were either never performed or were medically unnecessary and billed for X-rays performed by uncertified personnel. The complaint alleged that these fraudulent billing practices had continued for at least two years.  The individual whistleblower brought her action in the federal court and alleged violations of both the FCA and the State’s False Claims Act.  Both the federal government and State will recover funds in the $300,000 settlement of the case. The whistleblower stands to receive up to 25% of the settlement in accordance with 31 U.S.C. § 3730(d)(1).

Initiating a False Claims Qui Tam Action

The FCA provides specific procedures for initiating a case when an individual has credible information of fraud against the government.  Those procedures include filing a complaint under seal in the applicable court and disclosing confidentially to the government the “material evidence and information” the whistleblower possesses. 31 U.S.C. § 3730(b)(2).  The identity of the whistleblower (also known as the “relator”) is kept under seal while the government investigates the allegations of the complaint and the evidence submitted.  If an employer retaliates against the whistleblower, the whistleblower is entitled to bring a suit for wrongful retaliation and may be eligible for reinstatement, double back pay, and attorneys’ fees and costs.  31 U.S.C. § 3730(h).  Our litigators represent whistleblowers in these wrongful retaliation cases as well as in the underlying qui tam.

Contact Us

From start to finish, whistleblower cases take a long time, but the eventual rewards can make the effort worth it.  If you have credible information of fraud against the government, including under Medicare or Medicaid contact Ingrid M. Evans and the other California whistleblower attorneys at Evans Law Firm at (415) 441-8669, or toll-free at (888)-50EVANS (503-8267) or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>.   Ingrid and the other trial attorneys also represent individual cases involving bank fraud 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.

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