Missouri Qui Tam and False Claims Act Violations

Providing Legal Defense for Qui Tam and False Claims Act Charges throughout Missouri

The Criminal Defense Firm uses its significant experience to work on cases in the areas of regulatory compliance, corporate structuring, litigation, government investigations, and criminal defense. Among our health care, law defense firm is the former Chief Health Care Fraud Coordinator at the U.S. Attorney’s Office, former senior Department of Justice trial attorneys, former lead prosecutors of the elite Medicare Fraud Strike Force, and a slew of other attorneys with years of relevant experience and degrees from the country’s best law schools, such as Harvard and Yale. Our firm serves clients throughout Missouri and the surrounding areas.

In Missouri, violating the False Claims Act is an extremely serious matter. Investigations can be instigated against health care practitioners, facilities, organizations, or businesses. The Criminal Defense Firm provides strategic defenses for Missouri health care clients who are facing False Claims Act violations.

The State of Missouri Is Closely Monitored by the Federal Government

The federal government monitors the entire nation for False Claims Act violations. However, the State of Missouri is one of nine areas that is closely monitored by the Medicare Fraud Strike Force. This is because Missouri has a large number of people who benefit from federal health care programs. More claims are filed in the area, and that makes the federal government believe that there is a higher likelihood of False Claims Act violations. During 2016, the Department of Justice investigated more than 300 allegations and recovered more than $900 million in falsely paid out claims.

The Medicare Strike Force is a hybrid team of investigators and prosecutors from various federal agencies. You or your business may be contacted by the Department of Health and Human Services, the Department of Justice, the DEA, the Department of Defense, the FBI, and even the IRS. Often, other federal agencies are also involved. If you or your business is contacted by this team, contact The Criminal Defense Firm right away.

False Claims Act Basics

The False Claims Act is a federal law. It says that any individual or business that has direct or indirect contracts with and who will receive payment from the federal government for federal health care claims can be held civilly or criminally liable if they knowingly submit or cause the submission of a false claim that is to be approved and paid by the federal government. It applies to individuals, contractors, businesses, facilities, and organizations.

It is important that you understand that the word knowingly doesn’t just mean that you had actual knowledge related to the claim. It means that even if you didn’t know directly about the action that violated federal law, you should have known. Medical coding presents an easy way to show this as an example. When you hire someone to handle your coding and billing, it is ultimately your responsibility to ensure that the most current codes are used, and that appropriate billing takes place. If this person uses obsolete codes, you may be held legally responsible even if you did not have first-hand knowledge. The legal standard is that you should have verified that your coding had the most recent codes.

False Claims Act Violations May Result in Civil and Criminal Repercussions

Regardless of whether you are a doctor, nurse, or other types of health care provider, facility, or business in Missouri, violating the False Claims Act may result in civil and criminal repercussions. These penalties are serious and could affect you for the rest of your life. If you learn that you’re being charged with this serious federal violation, call The Criminal Defense Firm immediately. Once retained, we can assist you in finding out exactly which charges you may be facing.

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

Missouri Qui Tam Lawsuits Often Result in Investigations

Most False Claims Act investigations in Missouri begin because someone filed a qui tam lawsuit against a health care provider, facility, or business in federal court. The federal court used will ultimately depend on the city where you work. “Qui tam” is a shortened version of a Latin phrase that means (he who sues for the king and himself.) These lawsuits are incentivized because the original goal was to encourage private citizens to help stop others from defrauding the government. Unfortunately, this once noble act has turned into a litigious way to punish others. In Missouri, qui tam lawsuits are most often filed by angry former workers and unscrupulous competitors with the goal of punishing your business or practice.

When the qui tam lawsuit is filed, it is sealed by the court. The presiding judge and the federal agencies involved are the only people who receive an unsealed copy. A sealed copy protects the identity of the plaintiff. The plaintiff is listed only as the “qui tam realtor.” In Missouri, False Claims Act investigations can take a lot of time. The court allows extensions to be filed and granted so that the federal government has ample time to complete the investigation.

You will receive subpoenas for various records including your billing and financial statements. Subpoenas could come from the DOJ, DEA, DOD, IRS, FBI, OIG, or any number of federal agencies. The government will review your records and determine whether they will support or decline the lawsuit. If the government declines to get involved, the lawsuit isn’t over. The plaintiff can pursue the lawsuit. If they win, they will be rewarded with 30 percent of the recovered funds. If the government elects to support the qui tam lawsuit, you will likely face additional charges. If the qui tam suit is successful against you, the plaintiff who initiated it will receive 25 percent of the recovered funds as a reward.

If you’re served as a named defendant of a qui tam lawsuit, call The Criminal Defense Firm immediately. We can help you by establishing a strategic defense or working to settle with the federal government on your behalf.

Key Strategies for Missouri Clients

The Criminal Defense Firm utilizes key strategies to assist our health care clients in Missouri. Our three most important strategies were developed by putting our experience to use as former prosecutors of health care fraud and as defense team.

1. The most important objective is to reduce the risk of criminal charges against our Missouri clients. We get into immediate contact with the investigating federal officials. Our goal is to find out what the investigation is about, the potential charges faced by our clients, and what can be done to resolve the allegations. We can usually provide these answers within days of our engagement. Throughout our time as defense lawyers, we’ve learned that the best way to successfully resolve an investigation is to get involved as soon as possible.
2. In Missouri qui tam lawsuits, we work to discredit the allegations and the evidence involved. Our goal is to show the government that the case shouldn’t be supported and that it has no merit. This is important since most Missouri qui tam lawsuits aren’t filed with honest purposes of protecting the government. Our goal is to help protect Missouri health care providers, facilities, and related businesses.
3. When the federal government indicates that our clients are subject to civil liability, we work to negotiate the original damage request down to a fraction. None of our clients have been forced to close down their practice or business.

The Criminal Defense Firm

The Criminal Defense Firm serves health care clients in Missouri. We’ve represented ARNPs, doctors, nurses, hospitals, clinics, practice owners, physician-owned businesses, hospice centers, labs, pharmacies, and other health care businesses accused of False Claims Act violations or named qui tam defendants. We work with those being investigated for violating Stark Law and the Anti-Kickback Statute or involved in Medicare, Medicaid, Tricare, or Department of Labor investigations.

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 Missouri and if you’re being investigated by the federal government for violating the False Claims Act, you should call The Criminal Defense Firm right now. Initial consultations are free and totally confidential.

False Claims Act Defense Attorneys Serving the State of Missouri

We are available to discuss your case. You can call us directly, use our contact form, or send 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 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.