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Jan 24, 2024 by |

Los Angeles False Claims Act Whistleblower Attorney: Pharmacy Agrees To Pay $800,000 To Resolve Claims Of False Billing

ATTORNEY NEWSLETTER

Supplements Allegedly Never Ordered Or Delivered

Government Payments Under Illness Compensation Program

Private Individual Blew Whistle

Much government fraud occurs in the healthcare field.  Payments under government programs like Medicare, Medicaid (Medi-Cal in California), the Veteran’s Administration and certain government-sponsored workers compensation programs may be made on fraudulent claims, and that is where private individuals can help the government recover funds paid out on fraudulent (false) claims.  Specifically, private citizens help the government recover billions of dollars every year in cases of fraud against the government.  The cases are brought in federal courts throughout the country under the False Claims Act, (“FCA”), 31 U.S.C. § 3729 et seq.  The private individuals bringing the cases are referred to as “relators,” and the cases themselves are called “qui tam” cases. If the government recovers, the individuals bringing the lawsuits are eligible for rewards. 31 U.S.C. § 3730(d).   Relators of fraudulent conduct are often employees or managers, or former employees or managers, or (in healthcare cases) patients of the business engaging in the fraud.  If you have credible information of fraud against the government in violation of the FCA or Anti-Kickback Statute in Los Angeles or elsewhere in California, call us today at (415)441-8669 and we can help. Our toll-free number is 1-888-50EVANS (888-503-8267).

Recent Settlement[1]

In a recent press release by the U.S. Department of Justice (DOJ), a pharmacy has agreed to pay $800,000 to resolve allegations that it violated the False Claims Act by knowingly billing the U.S. Department of Labor for a compound supplement that was either not ordered by a licensed healthcare provider or was never delivered to beneficiaries. The Department of Labor provides benefits authorized by the Energy Employees Occupational Illness Compensation Program Act including compensation and payment of medical expenses to eligible claimants who were injured or became ill on the job, or to their families.  “An important part of the mission of the Office of Inspector General is to investigate allegations of fraud involving the U.S. Department of Labor’s (DOL) Office of Workers’ Compensation Programs (OWCP) programs. We will continue to work with OWCP to protect the integrity of DOL’s workers’ compensation programs,” said Mathew Broadhurst, Special Agent-in-Charge, Southeast Region, U.S. Department of Labor, Office of Inspector General.

The civil settlement includes the resolution of claims brought by private individuals, on behalf of the United States, under the qui tam (commonly known as “whistleblower”) provisions of the False Claims Act. The whistleblower will receive a portion of the $800,000 settlement as a reward.

How A Qui Tam Action Begins

Any False Claims Act whistleblower case begins by a relator filing a complaint under seal in the federal court usually for the District in which the defendant is located or does business. At the same time, the relator submits a disclosure to the DOJ outlining the material evidence the relator has of the alleged false claims. 31 U.S.C. § 3730(b). The seal period of the complaint lasts 60 days during which the DOJ investigates the claims.  31 U.S.C. § 3730(b)(2). (If necessary, the government can, and often does, extend the 60-day period during which the allegations are kept under seal.)  If the government decides to intervene in the case, the government essentially takes over the litigation. 31 U.S.C. § 3730(c)(1).   If the government declines to intervene, the relator may proceed with the litigation on his or her own.  31 U.S.C. § 3730(c)(3).

Contact Us

If you have credible information of government fraud in Los Angeles or elsewhere in California, call Ingrid M. Evans at (415) 441-8669, or toll-free at 1-888-50EVANS (888-503-8267) or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>.  In addition to FCA and CFCA whistleblower cases, Ingrid and Evans Law Firm, Inc. also handle bank fraud whistleblower cases 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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