9655 Perkins Rd, Suite C-203
Baton Rouge, LA 70810
225-269-8749
(Meeting location by appointment only)
Experienced Legal Defense for Health Care Fraud, False Claims Act and Qui Tam Investigations throughout Louisiana
A subpoena from a False Claims Act investigative team would turn your entire health care practice or business upside down. The Criminal Defense Firm provides custom and strategic defense for health care professionals, businesses, and facilities in Louisiana. Our Health Care Fraud Defense Team is experienced in helping clients navigate through this stressful time. If you’re under investigation because of an allegation that you violated the False Claims Act, don’t delay. Call The Criminal Defense Firm right away. We’re available 7 days a week.
Louisiana and False Claims Act Investigations
The Department of Justice released their 2016 statistics related to their medical fraud investigations. They had a record-breaking 300 cases in a single year since they implemented the Medicare Fraud Strike Force. Out of those cases, 60 involved doctors, nurses, and other licensed health care professionals. The rest of the cases involved health care facilities, pharmacies, and other healthcare-related businesses. The federal government calculated that these claims were worth more than $900 million combined.
Louisiana health care providers, facilities, and businesses face a higher risk of False Claims Act investigations. Louisiana is one of nine areas in the United States that the federal government believes is at a higher risk of medical fraud. As such, 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.
False Claims Act investigations are serious matters. If you’re involved in an investigation, you should contact and retain a health care fraud defense attorney right away.
What Is the False Claims Act?
The False Claims Act is a federal law. 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, “knowingly” is defined by the government to mean that you knew or you should have known that whatever happened to trigger the investigation was a violation of federal law. Yet, in our experience, we’ve learned that most violations aren’t a result of criminal intent. It’s most often the result of human error. Take the development of the ICD-10 as an example. If you or someone in your office used an older code, it could trigger a violation. This is because you and your team members had an obligation to perform due diligence research to use the right code since the codes changed.
Even though violations in Louisiana are often the result of human error, you can still face criminal and civil liability. Your case could be heard in both the civil and criminal courts. In the civil court, you could be assessed with treble damages. This means that you would pay the government three times the amount that it paid on fraudulent claims. You could also be fined up to $11,000 per false claim.
Criminal liability can result in a prison sentence of five years and fines. The amount of the fine will depend on whether you’re charged with a misdemeanor or a felony. It will also depend on whether you are an individual or an organization.
- 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.
Qui Tam Lawsuit Basics
The majority of False Claims Act investigations in Louisiana don’t start because the federal government randomly picks a health care provider or business. They often start because an angry former employee or competitor files a qui tam lawsuit in Louisiana district court. A qui tam lawsuit is when a private citizen (as opposed to the federal government) files a lawsuit against you on behalf of the government. Qui tam is Latin for “he who sues for the king and himself.” The goal behind a qui tam lawsuit is to help the federal government recover money that it paid for fraudulent claims. When a qui tam case is successful, the private citizen also gets a reward. Yet, when these lawsuits are filed in retaliation by former employees or competitors, the motive isn’t as pure as helping out the federal government.
Qui tam plaintiffs, known as qui tam relators, file their cases in Louisiana district court. These lawsuits are sealed to protect the identity of the plaintiff. In instances of true whistleblowing, this would be effective. Unsealed copies of the complaint are provided only to the presiding judge and specific government officials. Federal investigations can take months. Extensions are often granted in qui tam lawsuits to allow the government adequate time to investigate the claims.
The federal government will contact you to begin its investigation. You may be contacted by the FBI, DEA, OIG, DOJ, DOD, and HHS. Your billing, corporate, financial, and communication records will be subpoenaed. At the beginning of the investigation, you should retain a health care fraud defense attorney, as your attorney can contact the governmental entities involved to answer any questions that you have and to help you resolve the investigation.
After the investigation, the federal government can either decline to support the qui tam lawsuit, or it can choose to support it. Even if the government declines, the qui tam lawsuit can continue. If it chooses to support the claims made against you, it is known as an intervention. You may also face additional charges such as violations of the Truth in Negotiation Act and the Anti-Kickback Act.
Proven Defenses for Your Case
The Criminal Defense Firm utilizes its experience to successfully negotiate and defend False Claims Act cases in the United States. We provide strategic defenses based on the facts of each individual case. We do this by following a core set of guidelines that were developed to minimize risk to our clients.
- We provide early intervention. During our experience, we’ve learned that contacting federal investigators or prosecutors early in the investigative period is one of the best ways to defend our clients. We’re able to get answers to questions that you have. We’ll help you determine if you’re facing civil or criminal charges (or both) usually within a couple of days. We’ll also help you find out the ultimate goal of the investigation, and what can be done to resolve the issues. Getting answers to these questions can help us protect your professional licenses, your business, and your livelihood.
- Qui tam defenses. Since most Louisiana qui tam lawsuits begin because of a lawsuit filed by a former employee or competitor, we challenge the evidence presented in the lawsuit. Then we attack the credibility of the source. Proving to the federal government that the claims are biased is one of the ways that we can minimize the potential of government intervention. The federal government is less likely to support a qui tam lawsuit that has unfounded claims.
- Settlement of claims. We’ve successfully negotiated civil damage amounts to just a fraction of the original demands of the federal government in former cases. To date, none of our clients were forced to quit their practice or shut down their business because of a violation of the False Claims Act.
False Claims Act investigations are time-consuming and are a legitimate threat to your livelihood. You must take these investigations very seriously. A successful resolution is possible with early intervention by The Criminal Defense Firm Call us immediately to discuss your case. Initial consultations are confidential and free of charge. Call us 7 days a week. You can also use our online contact form or email us 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.
We are available to discuss your case. You can call us directly or complete our contact form or by sending us an email.
This information has been prepared for informational purposes only and does not constitute legal advice. This information may constitute attorney advertising in some jurisdictions. Reading of this information does not create an attorney-client relationship. Prior results do not guarantee similar future outcomes. The Criminal Defense Firm is a Texas firm with headquarters in Dallas.