Experienced Health Care Fraud Defense Team Serving the Portland Area
The Criminal Defense Firm, a Dallas-based health care law defense firm with significant experience in the areas of regulatory compliance, corporate structuring, litigation, government investigations, and criminal defense. Among our attorneys is the former Chief Health Care Fraud Coordinator at the U.S. Attorney’s Office, former senior Department of Justice trial attorneys, and former lead prosecutors of the elite Medicare Fraud Strike Force. Our talented attorneys have years of relevant experience and studied at the country’s best schools, such as Harvard Law School and Yale Law School. We serve clients in Portland and throughout the state of Oregon.
Portland, Oregon health care providers, facilities, clinics, and businesses face a growing risk of investigation for False Claims Act violations. The Criminal Defense Firm provides defense for Portland, Oregon clients who are accused of violating the False Claims Act.
Why More Portland Practitioners Face This Risk
The federal government investigates False Claims Act violations across the entire nation. However, they use the Medicare Fraud Strike Force to pay particular attention to nine areas in the nation. Portland, Oregon is one of those nine areas. Portland is targeted by the federal government because there is a higher number of federal health care program beneficiaries. This increases the number of claims filed through CMS. The federal government believes that there are higher instances of False Claims Act violations in areas where there are more federal claims filed. In 2016, the Department of Justice released a statement that they investigated more than 300 allegations and that they had recovered more than $900 million in illegally paid out claims.
The Medicare Fraud Strike Force is a federal task force that is made up of investigators and prosecutors from many federal agencies including the IRS, the DEA, DOJ, DOD, FBI, OIG, and the Department of Health and Human Services. It’s not uncommon for other federal agencies to be involved. An allegation that you’ve violated the False Claims Act is an extremely serious matter. Contact The Criminal Defense Firm right away for a free and confidential initial consultation.
What Is the False Claims Act?
The False Claims Act is a federal law that is directed toward any individual or business that has direct or indirect contracts with and who will be paid by the federal government for federal health care claims. It creates civil and criminal liability for individuals, contractors, businesses, or organizations that knowingly submit or cause the submission of false claims for the approval of and payment by the federal government.
In relation to the law, “knowingly” is an extremely important word. It is more than having actual knowledge that a crime has occurred. Rather, it is a direct reference to the fact that you knew or that you should have known that whatever was happening would be a violation of the False Claims Act. For instance, if you outsource your ICD coding, it is up to you to know whether or not the company uses the most up-to-date codes and follows proper billing protocols.
Civil and Criminal Penalties Under the False Claims Act
Portland health care providers, businesses, and facilities charged with violating the False Claims Act may face serious civil and criminal penalties. Your entire professional reputation and life are on the line. Call The Criminal Defense Firm right away. Once retained, we can assist you in finding out whether you’re facing civil or criminal charges. We can help you get the answers that you need.
Civil penalties may include one or more of the following:
- Treble damages paying the government three times the amount of the original claim
- Payment of civil fines of up to $11,000 per false claim
- Recoupment requests
- Non-payment of future submitted claims
- Future exclusion from federal health care programs
- State licensure or disciplinary proceedings
- Loss of hospital privileges
Criminal penalties may include one or more of the following:
- Claims that cost you hundreds of thousands of dollars
- Criminal charges
- Up to five years in federal prison
How Do Most False Claims Act Investigations Begin in Portland?
In Portland, Oregon, most False Claims Act investigations start because someone files a qui tam lawsuit. Qui tam is a Latin phrase that means “he who sues for the king and himself.” Originally, qui tam lawsuits were used by private citizens who were acting as whistleblowers to help the federal government recover money that they paid out on false claims. However, these suits are abused in Portland. They’re regularly filed by disgruntled former workers and jealous competitors who just want to hurt your business.
For Portland, qui tam lawsuits are filed in the District of Oregon federal court. Qui tam plaintiffs are known as “qui tam realtors.” Their identity is sealed by the court. It is only available to the assigned judge and the involved agencies. False Claims Act investigations can be lengthy. Extensions are often filed and granted to allow the government the time that they need to finish their investigation.
During the investigation, you’ll have your business, financial, communication, and billing records subpoenaed. The subpoenas can come from the DOJ, DEA, DOD, IRS, FBI, OIG, or other federal agencies. The government will review the records and determine whether they want to support or reject the qui tam lawsuit. If the government rejects the qui tam lawsuit, it’s not completely finished. The plaintiff will have the option of continuing the case without the support of the government. If they win without the government’s assistance, they’ll receive 30 percent of the recovered funds. If the government chooses to support the case, this is known as an intervention. You could face additional charges. If you lose the qui tam lawsuit, the plaintiff will be entitled to receive 25 percent of the recovered funds.
If you are notified that you’re a defendant in a qui tam lawsuit, call The Criminal Defense Firm immediately. Our Health Care Fraud Defense Team can help defend the charges and work toward a successful settlement on your behalf.
Key Defenses for Portland, Oregon Clients
The Criminal Defense Firm develops key defenses for each of our Portland clients using three main guiding principles. We developed these principles by relying on our collective experience as both defense attorneys and former federal health care fraud prosecutors. These principles are used with our clients throughout the United States.
- Our main goal is to minimize the risk of criminal charges for clients in Portland, Oregon. Once retained, we immediately contact the federal officials involved to determine the purpose of the investigation, find out the charges that you’re facing, and how the investigation can be resolved. We can usually get answers to these questions in just a few days. Experience has taught us that early intervention is key to a successful resolution of the investigation.
- When a False Claims Act investigation is the result of a qui tam lawsuit, we work to discredit the allegations aimed against you to show that the case doesn’t deserve the support of the federal government. This is vital because most qui tam lawsuits aren’t filed to protect the government, but simply to harm Portland, Oregon health care providers, businesses, and facilities.
- When civil liability is indicated by the federal government, The Criminal Defense Firm works to negotiate on your behalf with the federal government. We’ve successfully negotiated original damage amounts to a fraction of the original demand. None of our False Claims Act clients have been forced to shut down their health care practice or business.
The Criminal Defense Firm
The Criminal Defense Firm serves clients in Portland, Oregon, and the surrounding area. We’ve helped nurses, ARNPs, doctors, clinics, hospitals, practice owners, physician-owned businesses, labs, pharmacies, hospice facilities, and other health care businesses accused of violating the False Claims Act, that was named as defendants in a qui tam lawsuit, or being investigated for violating Stark Law, the Anti-Kickback Statute, or involved in Medicare, Medicaid, Tricare, or Department of Labor investigations.
Here’s a small portion of our Track Record:
- False Claims Act Investigation (Pharmacy)
Result: No Liability.
- False Claims Act Investigation (Pharmacy)
Result: No Liability.
- False Claims Act Investigation (Laboratory Group)
Result: No Liability.
- False Claims Act Investigation (Laboratory Group)
Result: No Liability.
- False Claims Act Investigation (Laboratory Group)
Result: No Liability.
- False Claims Act Investigation (Physician)
Result: No Liability.
- False Claims Act Investigation (Physician)
Result: No Liability.
- False Claims Act Investigation (DME Company)
Result: No Liability.
- False Claims Act Investigation (MSO)
Result: No Liability.
- False Claims Act Investigation (MSO)
Result: No Liability.
- False Claims Act Investigation (Physician Syndication)
Result: No Liability.
- False Claims Act Investigation (Physician Syndication)
Result: No Liability.
- False Claims Act Investigation (Physician Syndication)
Result: No Liability.
- False Claims Act Investigation (Device Company)
Result: No Liability.
- False Claims Act Investigation (Health Care Service Provider)
Result: No Liability.
If you’re in the Portland, Oregon area and you’re being investigated for a False Claims Act violation or if you’ve been named as a defendant in a qui tam lawsuit, call The Criminal Defense Firm right away. Initial consultations are always free and totally confidential.
We are available to discuss your case every day of the year. You can call us directly, use our contact form, or send us an email.
207-222-7742
The Criminal Defense Firm
Serving Portland, Oregon and Surrounding Areas
CriminalDefense.com