At Issue: Legal Standard Of “False”
Lower Courts Divided On Issue
Despite Uncertainties, False Claims Act Cases Increase
Individuals with knowledge of fraud against the government are entitled by law to bring cases (known as qui tams) on behalf of the government against corporations defrauding the government. These qui tam actions are brought under the False Claims Act (FCA), 31 U.S.C. § 3729 et seq. Qui tam cases are one of the most powerful tools in our country for fighting fraud; last year alone the government (and we the taxpayers) recovered over $2.2 billion by means of qui tam actions. The number of FCA actions filed has increased substantially in recent years, with more than 4,100 new cases opened since 2015, and 922 new FCA actions just last year. The whistleblower attorneys at Evans Law Firm, Inc. represent individuals (known as “relators”) who bring these qui tam cases based on the credible information they have pof fraud against the government in the healthcare field (Medicare and Medicaid fraud), government contractor work, sales of drugs subject to government approval, and more. If you have credible information for a false claims whistleblower case or any other whistleblower case in Marin County or elsewhere in California, call us today at (415)441-8669 and we can help.
Determining What Is “False”
The question of how to prove falsity in these cases is a critical one, as you may suspect. The courts apply somewhat different standards throughout the country. One such issue is this one: does something have to be objectively false or can a plaintiff establish falsity by opinion testimony? The United States Supreme Court recently declined to resolve a split on this issue within the courts. In denying petitions for writs of certiorari in Care Alternatives v. United States, ___ U.S. ___, 2021 WL 666386 (Feb. 22, 2021) and RollinsNelson LTC Corp. v. U.S. ex rel. Winters, ___U.S. ___, 2021 WL666435 (Feb. 22, 202), the Court left unresolved whether FCA liability must be predicated on a claim that is objectively false based on verifiable facts, or whether dueling expert opinions based on judgment can suffice to establish falsity. Unfortunately, this issue now joins a host of other questions on which the federal courts have been unable to provide uniform answers in connection with this powerful law enforcement tool.
Because the Supreme Court denied certiorari in RollinsNelson LTC Corp., the Ninth Circuit’s ruling in that case stands. There, the health care management company RollinsNelson was alleged to have submitted Medicare claims falsely certifying that certain inpatient hospitalizations were medically necessary. The Ninth Circuit concluded that “the FCA does not require a plaintiff to plead an ‘objective falsehood’” because a “physician’s certification . . . can be false or fraudulent for the same reasons any opinion can be false or fraudulent,” including “if the opinion is not honestly held.” Winter ex rel. United States v. Gardens Regional Hosp. & Med. Ctr., Inc., 953 F.3d 1108 (9th Cir. 2020), cert. denied sub nom. RollinsNelson LTC Corp. v. U.S. ex rel. Winters, No. 20-805, 2021 WL 666435 (U.S. Feb. 22, 2021).
Rewards For Blowing The Whistle On Government Fraud
The Ninth Circuit thus follows a relatively relaxed reading of falsity that does not require a plaintiff-relator to allege actual, objective falsehood. Individuals with information of government fraud here in California thus can proceed with their cases without establishing an “objective falsehood.” If the individual with such information of the fraud is a currently employed individual (such as an employee of a healthcare provider or government contractor), the employee/relator is protected from employer retaliation for bringing a qui tam case. 31 U.S.C. § 3730(h). If you are fired because you brought any fraud to light, you can fight back under the law. You may be entitled to sue your employer and seek double back pay (with interest), reinstatement, reasonable attorneys’ fees, and reimbursement for certain costs in connection with the litigation. 31 U.S.C. § 3730(h)(2). The litigators at Evans Law Firm, Inc. can represent you in any action for retaliation as well as represent you in your underlying whistleblower application. We know how to investigate and litigate retaliation cases with the aim of obtaining our clients all relief available under all governing laws.
Call Ingrid M. Evans and our other Marin County whistleblower attorneys today at (415) 441-8669, or by email at <a href=”mailto:firstname.lastname@example.org”>email@example.com</a> if you have information that may be the basis of a False Claims Act qui tam action. Ingrid and the other Evans Law Firm, Inc. whistleblower attorneys 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.
 Evans Law Firm, Inc. was not involved in any way in either case.