Settlement Of Multiple False Claims Allegations
Kickbacks, Overbilling For Suspended Provider Services And Devices
Former Executive Brought Case
Individuals with information of fraudulent claims for reimbursement for health care services from the government can bring actions on behalf of the government to recover the money paid out on false claims. The federal False Claims Act, 31 U.S.C. §§ 3729 et seq. (FCA) and similar California False Claims Act, Cal. Gov’t Code § 12650 et seq. (CFCA) both provide for damages and penalty recoveries to the government and rewards for the individuals, called “relators.” Defrauding health care providers may include hospitals, medical device manufacturers, drug makers, infirmaries, clinics, pharmacies, nursing homes, physician groups, diagnostic labs, therapy providers, home health care agencies and others. Evans Law Firm, Inc. represents whistleblowers in qui tam cases in Orange County and throughout California. If you have credible information of fraud against the government that may be the basis for a whistleblower or qui tam case, call us today at (415) 441-8669 or toll free at 1-888-50EVANS (888-503-8267).
Recently Settled Medical Hardware Case
The U.S, Department of Justice (DOJ) recently announced a settlement of $37.5 million to resolve allegations of violations of the False Claims Act and the California False Claims Act. The settlement is a joint resolution with the U.S. Department of Justice and the California Department of Justice. The settlement agreement with the hospital group settled allegations of kickbacks paid by the hospital to physicians for using the hospital’s services for implanting medical hardware in patients and other allegations. Specifically, the settlement resolves allegations that the hospital deliberately overpaid a physician to purchase his practice as a kickback, billed for a physician’s services even after he had been suspended from Medicare and billed Medi-Cal, the Federal Employees Health Benefits Program and the U.S. Department of Labor’s Office of Workers’ Compensation Programs for false claims based on inflated invoices for implantable medical hardware. The settled case was brought by a former executive at the hospital. The relator will receive $9,929,656 as a reward for bringing the case.
How Qui Tam Cases Begin
Individuals with original and credible information of false claims, like the former executive in this case, begin qui tam cases by filing a complaint under seal in the federal or California State court depending on whether the action is brought under the federal or State FCA. At the same time, the relator submits a disclosure to the government outlining the material evidence the relator has of the alleged false claims. 31 U.S.C. § 3730(b)(federal); Cal. Gov’t Code § 12652(c)(3). The seal period of the complaint lasts 60 days during which the DOJ investigates the claims. 31 U.S.C. § 3730(b)(2); Cal. Gov’t Code § 12652(c)(4). If the government decides to intervene in the case, the government essentially takes over the litigation. 31 U.S.C. § 3730(c)(1); Cal. Gov’t Code § 12652(c)(6)(A). 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); Cal. Gov’t Code § 12652(c)(6)(B).
If you have information regarding a whistleblower or qui tam case for any kind of healthcare fraud against the government here in San Francisco, contact Ingrid M. Evans at (415) 441-8669 or toll free at 1-888-50EVANS (888-503-8267), or by email at <a href=”mailto:email@example.com”>firstname.lastname@example.org</a>. In addition to False Claims Act cases, Ingrid also handles bank fraud whistleblower cases under the Financial Institutions Reform, Recovery, and Enforcement Act (FIRREA), commodities and futures trading cases under the Commodities Futures Trading Commission Whistleblower Program, securities fraud cases under the Securities and Exchange Commission Whistleblower Program and FINRA Whistleblower Office and offshore tax evasion and other tax fraud cases under the Internal Revenue Service Whistleblower Office.
 Evans Law Firm, Inc. was not involved in the case in any way.