Experienced Health Care Fraud Defense including False Claims Act and Qui Tam Investigations for the Laredo Area
Getting a subpoena from the government that you or your health care business is being investigated for violating the False Claims Act can plunge your entire world into chaos. The Criminal Defense Firm provides a passionate, customized, and strategic defense for health care professionals, businesses, and facilities in Laredo, Texas. Our Health Care Fraud Defense Team has the experience that you need to help you navigate confusing and anxiety-provoking requests from these federal government investigations. If you’re under investigation because of an allegation that you violated the False Claims Act, don’t wait. Call The Criminal Defense Firm now. We’re available 7 days a week.
False Claims Act Investigations
The Department of Justice recently released statistics of their 2016 medical fraud investigations. Out of a record-breaking 300 cases in a single year since the birth of their Medicare Fraud Strike Force, 60 claims involved doctors, nurses, and other licensed professionals. The rest of the cases involved health care facilities, pharmacies, and other healthcare-related companies. The amount of money lost by the federal government is stated to be more than $900 million.
Laredo, Texas health care providers, facilities, and businesses are at a higher risk of facing these devastating allegations. This is because Texas is one of nine areas in the nation believed to be a bigger risk to the federal government with this type of fraud. False Claims Act investigations are performed by the Medicare Fraud Strike Force, along with the Health Care Fraud Prevention and Enforcement Action Team (HEAT). These agencies are made up of investigators and prosecutors from multiple federal agencies including the FBI, Office of the Inspector General, Department of Health and Human Services, Department of Defense, and the Department of Justice.
These allegations are extremely serious. You should retain a health care fraud defense attorney right away.
False Claims Act Basics
The False Claims Act is a federal statute. It is directed toward any person or business that has either direct or indirect contracts with and is paid by the United States government. It presents a legal liability for any person, organization, corporation, or government contractor who knowingly submits or is the cause of submittal of a bogus or fraudulent claim for payment by the government.
However, the everyday definition of the word “knowingly” is much different than the government’s legal definition. It means that you knew or you should have known that what happened was a violation of the federal statute.
In our experience, we’ve discovered that most violations do not have criminal intent behind them. It is often the result of human error. For instance, the medical coding world recently changed with the development of the ICD-10. If you or someone in your organization uses an old code that happens to be wrong, you could be accused of violating the False Claims Act. This is because you or your employee should have known about the change and performed due diligence research to use the appropriate medical code.
Potential Civil & Criminal Liabilities
Although many False Claims Act violations in Laredo, Texas result from simple human error, as explained above, it can still cause you to face both civil and criminal liability. When the federal government first begins their investigation, you may not know if you’re facing civil or criminal penalties. The Criminal Defense Firm can help you by contacting the government on your behalf to determine your potential liabilities. It usually takes us only a couple of days.
Because you may face both civil and criminal liabilities, your case may be heard in both civil and criminal court. In civil court, you could be assessed with treble damages. This means that you would pay three times the amount of what the government paid out on each fraudulent claim. Additionally, you could be fined up to $11,000 per false claim.
Criminal liability could result in a prison sentence of five years. You could also be fined. The amount of the fine depends on whether you’re charged with a misdemeanor or a felony. It also depends on whether you’re facing the charges as an individual or as a company. Misdemeanors can be fined up to $100,000 per claim for an individual and up to $200,000 per claim for businesses. Felonies can be fined up to $250,000 per claim for individuals and up to $500,000 per claim for companies. You may also run the risk of having your professional license(s) revoked.
Facing a Qui Tam Lawsuit
Most of the False Claims Act investigations that occur in Laredo, Texas don’t happen because the federal government picked someone or some company randomly from the phone book. They usually start because an angry former employee or a competitor files a qui tam lawsuit in court. A qui tam lawsuit is when a private citizen files a claim on behalf of the federal government. Qui tam is Latin for “he who sues for the king and himself.” The original goal was the assist the federal government (the “king”) in recovering money that is rightfully it. When it is done successfully, the plaintiff gets to keep a portion of the recovery. However, when these suits are filed by former employees or competitors, the motive generally isn’t to be an upstanding citizen looking to right a wrong on behalf of the federal government.
Qui tam plaintiffs are referred to as qui tam relators. For Laredo, qui tam plaintiffs would file their case with the Southern District of Texas. These cases are sealed to protect the identity of the plaintiff. In a case involving a legitimate whistleblower, this would be important. However, it also provides a layer of protection for people who file these claims for no other reason than to punish you. Unsealed copies of the complaint are made available only to the presiding judge and certain government officials. Since a federal investigation can take months, extensions are often granted in cases.
After the case is filed, the federal government will contact you to begin its investigation. You may be contacted by the FBI, DEA, OIG, DOJ, DOD, and HHS. They will issue subpoenas to get copies of your billing, corporate, financial, and communication records. During the time that the government spends reviewing your records, it can be in contact with your chosen health care fraud defense attorney. This is important, because early intervention by The Criminal Defense Firm can help get answers to questions and help you resolve the issues.
The government can either decline to support the qui tam lawsuit, or it can support it. If it declines to support the care, the qui tam plaintiff can still pursue his or her case against you. If the government decides to support the case, this is known as intervention. You may then face additional charges such as violations of the Truth in Negotiation Act and the Anti-Kickback Act.
The Criminal Defense Firm Proven Defenses
The Criminal Defense Firm utilizes its experience to successfully negotiate and defend False Claims Act cases within the United States. Our Health Care Fraud Defense Team develops strategic defenses for each client while following a core set of guidelines to minimize the risk to our clients.
- Contacting investigators. We’ve learned that contacting federal investigators and prosecutors as soon as possible is one of the best ways to defend our clients. We can help you find out if you’re facing civil or criminal charges (or both). We can usually get this information within a couple of days. We will also find out the goal of the government’s investigation and how this issue can be resolved. Our goal is early intervention to help protect your professional license, your business, and your livelihood.
- Qui tam defense. Since most Laredo, Texas qui tam lawsuits originate from disgruntled former employees and devious competitors, we will challenge the evidence presented in the qui tam allegations. We will also attack the credibility of the source. Showing that the claims are biased or not credible is one of the best ways that we can defend you against government intervention. The government is less likely to provide support in a qui tam lawsuit if it is shown that the claims are unfounded.
- Settlement offers. We’ve successfully negotiated civil damage amounts to a small fraction of the government’s original demand in many of our former cases. To date, none of our clients had to quit practicing or close down their business because of a violation of the False Claims Act.
These investigations are time-consuming and threaten your livelihood. The key to a successful resolution is early intervention by The Criminal Defense Firm Call us right away to discuss the specifics of your case. Initial consultations are confidential and provided at no charge to you. Call us 7 days a week. You can also use our online contact form or send us an email to get started.
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 Serving Laredo, Texas
We are available to discuss your case. You can call us directly or complete our contact form or by sending us an email.