The Criminal Defense Firm possesses significant understanding of the practice of advising and defending clients in False Claims Act investigations. Our nationally acclaimed Health Care Fraud Defense Group is led by experienced and cogent legal personnel.
Dallas False Claims Act Investigations
There are only nine areas in the United States where the federal government has instituted specialized task forces to surveil, inspect, and prosecute violations of the False Claims Act. Of these cities, Dallas is one of the most prominent areas for government prosecution; health care professionals and organizations in Dallas must be aware of the increased aggression and frequency with which prosecutions are carried out as compared with other communities. These prosecutions are orchestrated by the elite Health Care Fraud Prevention and Enforcement Action Team (HEAT), a systematized federal task force comprised of prosecutors from the Department of Justice (DOJ), Department of Health and Human Services (HHS), the Office of Inspector General (OIG), the Federal Bureau of Investigation (FBI), and other governmental agencies.
False Claims Act Explained
The False Claims Act is a federal mandate that applies to any individual or business that either directly or indirectly engages with, and is reimbursed by the United States government. The False Claims Act holds people, organizations, corporations, and government contractors liable for knowingly submitting or causing the submission of a false or fraudulent claim with the intent of procuring payment or approval from the government. Knowingly submitting an inaccurate claim is an act quantified by the submission of the claim with actual knowledge, or when the person or entity failed to conduct due diligence. As an example, liability under the False Claim Acts emerges by default if a person should already have been aware of the changing of a billing code, but lacking due diligence research, proceeded to submit an outdated (false) code.
Civil & Criminal Liability in Dallas, Texas
Investigations incited by the False Claims Act in Dallas give way to acute challenges for any business. This is due to the fact that the statute includes both civil and criminal penalties; it is often unclear at the beginning of a case whether the government handles the matter through civil channels or aims to press criminal charges against the business owners. Here is a breakdown of the civil and criminal liabilities that you may face:
- Civil Liability: For any party that knowingly submits or causes the submission of a false or fraudulent claim to the United States government, they may be assessed treble damages and a penalty of up to $11,000 per claim.
- Criminal Liability: The filing of a false claim runs the risk of serving a five-year prison sentence and fines. The fines depend upon whether you’re facing a misdemeanor or a felony charge. It also depends on whether you are an individual or a business. A fine of $250,000 (individuals) or $500,000 (companies) may be assessed for federal felony convictions. Fines of $100,000 (individuals) or $200,000 (companies) may be assessed for each misdemeanor conviction. Please note that these fines will be accrued per claim.
What Is a Qui Tam Lawsuit?
In Dallas, most False Claims Act investigations are instigated not by the government, but by disgruntled former employees or competitors. Within the False Claims Act, there is a provision that provides for private citizens (relator) to file a qui tam lawsuit (short for the Latin phrase: “he who sues for the king and himself“) to recover money on behalf of the federal government. This is done by simply accusing an individual or a business of defrauding the federal government under the False Claims Act. In practice, this is how a qui tam lawsuit functions:
A complaint is filed by the plaintiff (the qui tam relator) against the defendant(s) (an individual, a business, or both). The complaint is filed with the U.S. District Court for the Northern District of Texas. In order to protect the anonymity of the plaintiffs, the court’s clerk files qui tams under seal and will provide copies of the private complaint only to specific government officials and the presiding judge. To keep the case sealed, regular six-month extensions of the seal are permitted. This also allows adequate time for the federal government to investigate.
The government will screen the case upon learning of the filed qui tam. They have the option to reject an unsubstantiated case. However, should the complaint prove persuasive, the government may see fit to investigate the facts with the assistance of federal law enforcement agencies, including the FBI, the DEA, the OIG, and other agencies. Investigation of this factual nature is usually executed via subpoenas that require the accused to produce specific corporate, financial, business, and communications records.
After reviewing those records and engaging in negotiations with your health care fraud defense attorneys, the government must cast its decision in favor of the plaintiff and intervene in the case, or whether it will abstain and leave the relator to continue on their own. Intervention necessitates an approval process that involves the Department of Justice’s Washington, D.C. headquarters. The Department of Justice will usually amend the complaint to contain additional causes of action, such as alleging that you’ve also violated the Anti-Kickback Act and the Truth in Negotiation Act.
While the government serves subpoenas, which notify defendants about the pending investigation in the process, the government and your health care fraud defense lawyers will undergo negotiations. Depending on the intricacies of the case and the examination, several months may pass before the government begins to evaluate a qui tam. Even more, time may lapse before a matter is fully settled.
The individuals and companies accused of violating the False Claims Act in the qui tam lawsuit, if found to be liable, could be required to pay up to three times the government’s losses in addition to sanctions of up to $11,000 per claim. Qui tam plaintiffs are incentivized by the law; plaintiffs are allowed to retain up to 25 percent of any amount collected should the government participate in the litigation and up to 30 percent on the condition that the plaintiffs collect on their own without governmental intercession.
Proven Defense Strategies
At The Criminal Defense Firm, our attorneys possess in-depth experience and have successfully resolved False Claims Act cases across the United States in Dallas, TX and several other locations. Thanks to our extensive understanding of False Claims Act investigations and defense strategies, we are aware of the difference between human error and liability: It is often a fine line that demands mastery of tactful negotiation, established industry experience, and attention to detail. Our guiding principles follow.
- No criminal charges when possible. Our utmost priority when dealing with any False Claims Act case is to avoid criminal charges for our clients. Our profound understanding of federal health care prosecution as it relates to False Claims Act investigations, as well as a targeted practice on health care fraud defense work, allows us to swiftly determine whether the investigation is civil or criminal, what the government’s intentions are, and how to resolve the matter in the most efficacious manner possible. We are capable of informing our clients within the first day or so, on average, regarding what the case is about, what exposure is available, and what the government hopes to do moving forward.
- No government intervention. False Claims Act cases are often instigated by unhappy ex-employees or competitors with dishonest schemes; as such, we will relentlessly challenge those parties, question their evidence, mercilessly dismantle their story, and annihilate their credibility. Such ruthless tactics are a necessity in order to convince the government of the worthlessness of the accusations, and that they are unworthy of government intervention and support.
- Favorable settlement. In occurrences in which civil liability was determined in our previous cases, we managed to negotiate restitution to a fraction of the government’s demand. To date, not a single False Claims Act settlement under our wing has resulted in the shutdown of any of our clients.
To discuss your circumstances with experienced health care defense attorneys, make it your priority to call The Criminal Defense Firm today. All initial consultations are free and confidential. You can reach us by calling us, completing our online contact form, or sending an email.
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.
We are available to discuss your case. You can call us directly or complete our contact form or by sending us an email.