William Nash filed a whistleblower case against his former employer but wanted to remain anonymous so that his new employer wouldn’t know that he is—you guessed it--a whistleblower. William’s qui tam action alleged Medicaid fraud by his former employer. When the government declined to intervene, William …
Yes, Virginia, There Is a Reverse False Claim
October 23, 2017 Leave a Comment
The False Claims Act has a scienter requirement: it makes it illegal to knowingly present a false claim to the government. So if a company innocently presents a false claim, it can’t be guilty of violating the Act, right? Well, not exactly. The answer may depend on whether the company later discovers the …
How to Get a 2,333% ROI?
September 22, 2017 Leave a Comment
Three affiliated home health companies in Tennessee agreed to pay $1.8 million to settle False Claims Act (FCA) liability. That’s a lot of money, but it’s only about four percent of the $42 million in potential liability that, according to BNA, federal prosecutors say the homes faced for false Medicaid …
Finally, Recovery of Attorney Fees for Government Overreach
September 21, 2017 Leave a Comment
There are two major, interrelated reasons why government contractors, including Medicare providers, are so afraid of the False Claims Act (FCA). One is the draconian nature of the liability: treble damages plus up to $21,916 in penalties per claim. That means, for example, a knowing overcharge of $5 on a single …
Maybe the Yacht Was the Tip-Off
September 20, 2017 Leave a Comment
If you’re a surgical device distributor and you want to reward a surgeon for using your products on Medicare and Medicaid patients, you may want to choose a reward that’s less conspicuous than a yacht. That’s one lesson in the recent decision in US ex rel. Cairns v. D.S. Med. In denying defendants’ …
Bad News for Whistleblowers: Defendant Pleads Guilty
August 23, 2017 Leave a Comment
At first glance, it looks nonsensical. How could it be bad news for False Claims Act whistleblowers that the defendant pleaded guilty to violating that statute—to committing the very Medicare fraud the whistleblowers alleged? The explanation lies in two legal principles and one fact. First, there’s a …