Defending Health Care Professionals across Missouri Against False Claims Acts Charges
Our “health care law defense firm” has significant experience in the areas of regulatory compliance, corporate structuring, litigation, government investigations, and criminal defense. The Criminal Defense Firm is made up of a diverse group of lawyers, including 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 other talented attorneys who have years of experience and degrees from the nation’s most prestigious law programs, such as Harvard Law School and Yale Law School. Our firm serves clients throughout St. Louis and the state of Missouri.
In the city of St. Louis, False Claims Act violations are extremely serious issues. Investigations can be initiated against health care providers, facilities, organizations, and businesses. The Criminal Defense Firm offers strategic and comprehensive defenses for St. Louis-area clients who have been placed in the predicament of facing False Claims Act violation allegations.
The St. Louis Area Is Closely Watched by the Government
The federal government has the entirety of the United States of America to worry about when it comes to False Claims Act violations. Despite this, the city of St. Louis is one of nine regions within the nation that is heavily monitored by the Medicare Fraud Strike Force. This is thanks to the fact that St. Louis has a large amount of federal health care program recipients; therefore, more claims are filed in areas with a large number of federal health care program recipients. According to information gathered by the federal government, the larger amount of claims filed translates into a higher likelihood that a False Claims Act violation will take place. In 2016, the Department of Justice released a statement announcing that they had launched investigations into more than 300 violations, and recovered more than $900 million in false claims as a result.
The Medicare Strike Force is a hybrid team of investigators and prosecutors from various federal agencies. You or your business may have contact with 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.
What Is the False Claims Act?
Explained simply, the False Claims Act is a federal law that is aimed at any person or business that makes direct or indirect contracts with and who will receive payment from the federal government for federal health care claims. This law holds liable (both criminally and civilly) individuals, contractors, businesses, or organizations who knowingly submit or cause the submission of a false claim that is to be approved and paid by the federal government.
It is pertinent to understand that perhaps the most important part of this law is the use of the term (knowingly.) “Knowingly” means that if you didn’t know that your actions would violate federal law, you should have known. A simple example is observed in medical coding. If you were to hire someone to complete your medical coding and billing on your behalf, it would be your responsibility to make sure that whoever is handling your medical coding and billing is not using obsolete codes or improper billing protocols.
Violating the False Claims Act May Result in Civil & Criminal Penalties
Doctors, nurses, ARNPs, other health care providers, facilities, and businesses that are charged with violating the False Claims Act in St. Louis may face both civil and criminal penalties. These penalties are extraordinarily serious and are able to affect you for the rest of your life. Should you discover that you are being charged with violating the False Claims Act, you need to call The Criminal Defense Firm right away. We can assist you by finding out the type of charge that you’re facing after we’re retained.
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
You are also at risk of losing your professional license, facing state disciplinary hearings, or losing your hospital privileges.
Qui Tam Lawsuits Start Many False Claims Act Investigations
In the city of St. Louis, most False Claims Act investigations are launched because someone filed a qui tam lawsuit in the district federal court. “Qui tam” is an abbreviation of a Latin phrase that, when roughly translated, means (he who sues for the king and himself.) Such lawsuits are incentivized by the government. Originally, the goal of the qui tam was to reward the private systems that assist the federal government by alerting them to fraudulent activity. Nowadays, however, it is a system that is commonly abused by disgruntled former employees and competitors. They are simply filed for the express purpose of punishing health care providers, facilities, and businesses.
Upon a qui tam lawsuit being filed, it is sealed by the court. The assigned judge and the involved federal agencies are the only parties who are provided with unsealed copies of the case. In the documents, the plaintiff is referred to as the “qui tam realtor.” False Claims Act investigations are a lengthy affair in St. Louis. The court allows there to be extensions filed in order to allow federal agencies to have enough time to finish their investigations.
During the course of the investigation, you will be issued subpoenas for various records. These subpoenas could come from the DOJ, DEA, DOD, IRS, FBI, OIG, or any number of federal agencies. The government will examine your documents and then make a decision to support or reject the lawsuit. In the instance that the government declines to support the lawsuit, it isn’t necessarily over; the plaintiff still has the option to pursue the lawsuit. If the plaintiff is successful in his or her crusade against you, then the party will be rewarded with 30 percent of the recovered funds. On the other hand, if the government opts to support the qui tam lawsuit (an action known as “intervention”), you are likely to be confronted with additional charges. If you lose the lawsuit, the plaintiff will be entitled to claim 25 percent of the recovered fund.
If you are served with a qui tam lawsuit, make it your top priority to call The Criminal Defense Firm as soon as you possibly can. We can assist you in developing a strategic defense, or, in appropriate cases, help you settle with the federal government.
Using Vital Strategies to Assist Our St. Louis Clients
The Criminal Defense Firm utilizes essential strategies to assist our clients in St. Louis. Our three most important strategies were developed by putting to use our experience as former prosecutors of health care fraud and as defense attorneys.
- The most important objective for us is to minimize the likelihood that our St. Louis clients will be confronted with criminal charges. We get into immediate and direct contact with the investigating officials to ascertain the purpose of the investigation, the potential charges and ask how this matter can best be resolved. We can usually provide the answers within a mere few days. We’ve learned that our method of early intervention is a vital strategy that is extremely essential to successfully resolve investigations.
- In qui tam lawsuits, we laboriously strive to discredit the allegations and the evidence in order to prove to the government that the case is not worthy of their support. This is extremely important, as most qui tam lawsuits in St. Louis are not filed for morally correct reasons. St. Louis health care providers, facilities, and businesses must be protected.
- When the federal government indicated that our clients are to face civil liability, we work to negotiate with the government to diminish the original demand down to a mere fraction. To date, absolutely none of our clients have been forced to close down their practice or their business thanks to an allegation of a False Claims Act violation.
The Criminal Defense Firm Serving St. Louis, MO
The Criminal Defense Firm serves clients in St. Louis and the surrounding area. We’ve represented nurses, ARNPs, doctors, clinics, hospitals, practice owners, physician-owned businesses, labs, pharmacies, hospice facilities, and other health care businesses accused of violating the False Claims Act, that was named as defendants in a qui tam lawsuit, or being investigated for violating Stark Law, 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 St. Louis or in the surrounding area 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 St. Louis
We are available to discuss your case. You can call us directly, use our contact form, or send us an email.
The Criminal Defense Firm
Serving St. Louis, MO and Surrounding Areas
CriminalDefense.com
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.