Biden Administration Makes FCA Enforcement A Priority
Focusing On Six Major Areas of Fraud
Fraud Against Elders A Priority
The Biden Administration is expected to devote significant resources to prosecuting fraud. This includes fraud against the federal government (in programs like Medicare and Medicaid and other federal aid programs). The major enforcement tool against government fraud is the power of cases brought by individual citizens brought under the False Claims Act (FCA), 31 U.S.C. § 3729 et seq. Biden appointees in the Department of Justice (DOJ) will encourage FCA actions (known as qui tams) in contrast to the prior administration’s initiative to dismiss many such cases. The DOJ in the Biden Administration has identified six areas of fraud that will be targeted by federal law enforcement in the coming years. This dedication of the Biden Administration is a welcome shift after the corporatist focus of the prior administration. The government (and taxpayers) recover billions every year as a result of individual qui tams and use of this important tool should be expanded not constricted. Evans Law Firm, Inc. represents individuals with information that can be the basis for a qui tam action. If you have credible information for a false claims whistleblower case or any other whistleblower case in San Diego or elsewhere in California, call us today at (415)441-8669 and we can help.
Fraud Priorities In The Biden Administration
In an appearance at the Federal Bar Association Qui Tam Conference earlier this year, Acting Assistant Attorney General Brian Boynton highlighted the six key FCA enforcement priorities of the Biden DOJ’s Civil Division: (1) pandemic-related fraud, (2) opioids, (3) fraud targeting seniors, (4) electronic health records, (5) telehealth and (6) cybersecurity. The litigators at Evans Law Firm, Inc. represent seniors in elder abuse cases and were encouraged to see that fraud against elders (and the government for medical services provided to seniors) will be a priority for the Biden DOJ. The DOJ has indicated that it will concentrate particularly on cases involving concerns about poor or unnecessary health care in skilled nursing facilities. Nursing facilities have come under heavy scrutiny throughout the COVID-19 pandemic, and such scrutiny is likely to continue, according to administration officials. Even before the pandemic, skilled nursing facilities faced heightened regulatory scrutiny with the DOJ’s launch of its “National Nursing Home Initiative” to “coordinate and enhance civil and criminal efforts to pursue nursing homes that provide grossly substandard care to their residents.” Central to many FCA actions involving skilled nursing facilities are allegations that treatments provided and paid for using government funds were not “medically necessary.” For example, in July 2020, DOJ reached a $16.7 million settlement involving affiliated skilled nursing facilities over allegations that they violated the FCA by submitting false claims to Medicare for rehabilitation therapy services that were not reasonable or necessary. Acting AAG Boynton’s remarks demonstrate that similar enforcement actions in this area will continue to be a priority for the Biden DOJ.
During the same Federal Bar Association conference, Senator Chuck Grassley (R-Iowa) said that the government needed to “come down with a sledgehammer, not a toothpick” against fraud. Senator Grassley, a co-sponsor of the 1986 Amendments to the FCA and a longtime proponent of the Act and its qui tam provision, also weighed in on some timely and controversial aspects of FCA litigation, including the ability of the Department of Justice (DOJ) to dismiss qui tam complaints. Senator Grassley also observed that times of national crisis are often accompanied by increased fraud, noting that he hoped that a recently announced FCA settlement related to the Paycheck Protection Program (PPP) was “a sign of things to come.”
The remarks of Senator Grassley and Acting AAG Boynton strongly indicate that FCA enforcement will be a DOJ priority and will likely expand during the Biden Administration.
Protection For Employees Who Blow Whistle
Any employee, former employee, or other individual with information of this kind fraud, files a qui tam case under the FCA he or she may be eligible for a reward if the government ultimately recovers from the wrongdoer. 31 U.S.C. §3730(d). Very often, the individual with information about fraud against the government is a current employee of the business defrauding the government. If the relator/plaintiff is an employee, 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). Our firm 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.
If you live here in San Diego and have information of fraud that could be the basis for an FCA qui tam action, call Ingrid M. Evans today at (415) 441-8669, or by email at <a href=”mailto:firstname.lastname@example.org”>email@example.com</a>. Ingrid also handles 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.