False Claims Act & Qui Tam Legal Defense Serving all of Texas
Receiving a subpoena from either of the False Claims Act investigative teams would be surprising and disjointing. The Criminal Defense Firm provides a customized and pragmatic defense strategy to health care professionals, businesses, and facilities in Texas. Our Health Care Fraud Defense Team is seasoned in assisting clients during this trying time. If you are currently under investigation due to allegations that you have violated the False Claims Act, there is no time to waste. Don’t delay. Call The Criminal Defense Firm We’re available to help you 7 days a week.
Texas and False Claims Act Investigations
In 2016, the Department of Justice released their medical fraud investigation-related statistics. These statistics revealed a record shattering 300 cases in a single year since the implementation of the Medicare Fraud Strike Force. Out of the 300 cases, 60 involved doctors, nurses, and other licensed health care practitioners and professionals. The remaining cases involved health care facilities, pharmacies, and similar healthcare-related businesses. The federal government’s calculations revealed that combined, these claims were worth more than $900 million.
In Texas, health care providers, facilities, and businesses find themselves at a higher risk of False Claims Act inquiries. Texas is one of nine areas in the United States that the federal government deems to be at a higher risk of medical fraud. As a result, False Claims Act investigations are launched by both the Medicare Fraud Strike Force and the Health Care Fraud Prevention and Enforcement Action Team (HEAT). These two agencies are comprised of investigators and prosecutors from a multitude of federal agencies, including the FBI, Office of the Inspector General, Department of Health and Human Services, Department of Defense, and the Department of Justice.
False Claims Act investigations are matters of dire seriousness. If you are involved in an investigation, you should make it a top priority to contact and employ the services of a health care fraud defense attorney as soon as possible.
What Is the False Claims Act?
Simply put, the False Claims Act is a federal law directed toward any person or business that has direct or indirect contracts with, and is paid by, the United States government. The law poses a legal liability for any person, organization, corporation, or government contractor who knowingly submits or is the cause of the submission of a fraudulent or falsified claim for payment by the government.
Nonetheless, the term “knowingly” is described by the government to mean that you were aware (or that you should have been aware) that the actions you took that resulted in the investigation were a violation of federal law. However, our experience tells us that most violations of the False Claim Act are not made with criminal intent. Most often, these violations are caused by human error. For example, the updated ICD-10 codes would be an easy culprit to incite a violation. If you or someone in your office used in older code, it could result in a violation of the law. This is due to the fact that you and your team members were obligated to perform due diligence research to use the correct code.
Despite the fact that violations in Texas are frequently the result of human error, you are still subject to face criminal and civil liability. Your case could be brought to both the civil and criminal courts. In the civil court, you face the possibility of being assessed with treble damages. In essence, this means that you would pay the government three times the amount that they paid out on the fraudulent claims. In addition, you could be fined up to $11,000 per false claim.
Criminal liability, on the other hand, can bring a prison sentence of five years and fines. The amount of your potential fine varies based upon whether you’ve been charged with a misdemeanor or a felony. The fine also depends on whether you are an individual or an organization. Misdemeanor fines can reach up to $100,000 per claim for an individual and up to $200,000 per claim for businesses. Felony fines can skyrocket up to $250,000 per claim for individuals and up to $500,000 per claim for companies. Furthermore, you are at risk of having your professional license(s) revoked.
Qui Tam Lawsuit Basics
Most False Claims Act investigations in the state of Texas are not initiated due to any sort of random action by the federal government. False Claim Act investigations are often instigated by a former employee or a competitor. A qui tam lawsuit occurs when a private citizen (rather than the federal government) files a lawsuit against you on the government’s behalf. Qui tam is a Latin phrase that is interpreted as (he who sues for the king and himself.) King is a reference used to describe the federal government. The aim of a qui tam lawsuit is to assist the federal government in recovering money that they paid out on bogus claims. Upon the success of a qui tam case, the citizen is also entitled to a monetary reward. As a result, these lawsuits are often filed in retaliation by former employees or competitors with intentions that are far less pure than simply helping out the federal government.
In qui tam lawsuits, the plaintiffs are frequently referred to as (qui tam relators.) Qui tam relators file their cases in the Texas district court. After these cases are filed, they are then sealed to protect the plaintiff’s identity. In cases where the plaintiff is truly acting as a whistle-blower, such anonymity is necessary. Unsealed copies of the complaint are provided only to the presiding judge and specific government officials.
The federal government will contact you as a start to their investigation. As such, you may be contacted by the FBI, DEA, OIG, DOJ, DOD, and HHS, who will subpoena your billing, corporate, financial, and communication records. At the beginning of the investigation, you should make it a priority to retain a health care fraud defense attorney. Your attorney can contact the government agencies involved in order to answer any questions that you may have and to assist you in resolving the investigation.
After the investigation’s closure, the federal government can either decline to provide their support to the qui tam lawsuit or they can choose to support it. Should they decide to decline, the qui tam lawsuit can continue with the plaintiff. If the government makes the choice to support the claims levied against you, it is known as an “intervention.” You could face additional charges such as violations of the Truth in Negotiation Act and the Anti-Kickback Act.
Proven Defenses for Your Case
At The Criminal Defense Firm, we utilize our experience to successfully negotiate and defend False Claims Act cases within the United States. We create strategic defenses based upon the facts of each individual case. This is achieved by adhering to a fundamental set of guidelines that were formulated to minimize the risk of our clients.
- We provide early intervention. Our experience has taught us that when we contact federal investigators or prosecutors in the early stages of the investigative phase, we produce the best outcome for our client. Were able to find the answer to any question you have. We’ll help you ascertain whether you’re facing criminal or civil charges, usually within the course of a couple of days. We’ll also work to help you discover the ultimate goal of the investigation and what can be done to resolve the issues brought to light by the investigation. Acquiring the answers to these questions help us to protect your professional license(s), your business, and your livelihood.
- Qui tam defenses. Due to the fact that the majority of qui tam lawsuits are instigated by a former employee or a competitor, we challenge the evidence presented in the lawsuit with voracious ferocity. We then proceed to shatter the credibility of the source. Our years of experience taught us that the best way to remove the federal government’s desire to intervene in the case is to bring to light the unfounded claims of the qui tam plaintiff.
- Settlement of claims. Throughout our time as an organization, we have successfully negotiated civil damage amounts to a small fraction of what the government originally demanded. To date, absolutely none of our clients have abandoned their practice or shut down their business as a result of a violation of the False Claims Act.
False Claims Act investigations are time-consuming affairs that can be lethal to your practice without the right allies on your side. Your journey to success, resolution, and, ultimately, peace of mind, begins with early intervention by The Criminal Defense Firm Begin your journey by calling us immediately to discuss your case. All initial consultations are confidential and completely free of charge. Our lines are open and waiting for your call 7 days a week. Alternatively, you can use our online contact form or you may email us to begin.
The Criminal Defense Firm
The attorneys of The Criminal Defense Firm have successfully defended physicians, practice owners, physician-owned entities, toxicology laboratories, device companies, pharmacies, service management organizations, health care marketing companies, hospitals, and many others in False Claims Act, qui tam lawsuits, Stark Law, Anti-Kickback, Medicare, Medicaid, Tricare, and DOL investigations.
- 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.
Call The Criminal Defense Firm today and speak with former federal prosecutors and established defense counsel about your case. All initial consultations are free and confidential.
False Claims Act Defense Attorneys in Texas
We are available to discuss your case. You can call us directly or complete our contact form or by sending us an email.