ATTORNEY NEWSLETTER

False Claims Lawsuit Spotlights Medicare/Medi-Cal Overbilling

False Claims

A false claims lawsuit against a nursing home alleging overbilling of Medicare and Medi-Cal recently settled for $54 million. The large false claims case was a whistleblower suit, also known as a qui tam. According to reports of the settlement, the case began in n 2012 when a registered nurse and patient care manager blew the whistle on the nursing home. Since then, as many as four other lawsuits against the company for false billing were also launched.

The allegations were that the nursing facility allegedly billed Medicare and Medicaid for hospice services to patients who were not authorized to receive them. In addition, Medicare and Medicaid reimbursed the nursing home for services never rendered to anyone. This kind of fraud against the government constitutes violations of the federal False Claims Act (FCA). The FCA awards whistleblowers for credible information of false claims by sharing up to 30% of the government’s recovery with the whistleblower as a reward. California has a State false claims act for similar fraud against the State of California.

While the awards in whistleblower cases are substantial, whistleblower cases are long and very complex. The government considers only original and credible information of false claims and there must be hard evidence such as authentic documentation that supports the information. We here at Evans Law Firm have years of experience with whistleblower and qui tam cases brought under the False Claims Act and US tax laws against tax avoidance schemes. We know what the government looks for in these cases and know how best to structure, organize, and present your evidence and documentation through initial application or complaint, discovery and investigation, and trial.

Contact Us

If you or a loved one has information regarding a whistleblower or qui tam case in any California county brought under the False Claims Act or under the Internal Revenue Code for prosecution of tax avoidance schemes including offshore schemes, contact the Evans Law Firm whistleblower and qui tam attorneys at (415) 441-8669, or by email at info@evanslaw.com. Our attorneys have experience with complex financial contracts and large insurance companies. We can help guide your case through a jury trial or toward an equitable settlement. We handle cases involving physical and financial elder abuse, qui tam and whistleblower law, nursing home abuse, whole life insurance and universal life insurance, and indexed, variable, and fixed annuities.