Legal Counsel for False Claims Act & Qui Tam Investigations in Miami, FL
Receiving a subpoena from the federal government because you’re being investigated for violating the False Claims Act could turn your entire professional world upside down. The Criminal Defense Firm provides customized, strategic defenses for health care professionals, facilities, and businesses in Miami, Florida. Our Health Care Fraud Defense Team provides experienced service and guidance in relation to the False Claims Act. Call The Criminal Defense Firm right away if you receive a subpoena or other notice alleging fraud. We’re available 7 days a week. Don’t delay. The sooner you retain counsel, the sooner you can get the answers that you need.
False Claims Act Investigations in Miami, Florida
In 2016, the Department of Justice released history-making statistics related to their False Claims Act investigations. Since they implemented the Medicare Fraud Strike Force, they’ve investigated more than 300 cases of medical fraud. More than 20 percent of those cases were asserted against doctors, nurses, and other licensed health care professionals. The other cases were brought against health care facilities, pharmacies, and other health care-related businesses. These claims were worth a total of more than $900 million.
Health care providers, facilities, and businesses located in Miami, Florida are at a higher risk of investigation than most other areas in the United States. This is because Miami is one of nine locations in the United States that the federal government believes has a higher rate of False Claims Act violations. Because of this, there are two investigative teams located in Miami: Medicare Fraud Strike Force, along with the Health Care Fraud Prevention and Enforcement Action Team (HEAT). These two investigative teams are comprised of prosecutors and investigators 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 incredibly serious matters that can affect your professional future. If you’re involved, contact and retain a health care fraud defense attorney immediately. This is the best way to protect your business and minimize your civil and criminal liabilities.
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.
Yet, there’s a difference between how individuals define the word “knowingly” and how the government defines it. The government defines it as a person or entity who knew or should have known that whatever happened would cause a violation of the False Claims Act.
Although most violations aren’t done with criminal intent, that doesn’t mean the human error will absolve you from legal liability. Something as small as using the wrong medical code can trigger an investigation. For example, if you or a member of your business used an obsolete code instead of an ICD-10 updated code, that could still be seen as a violation of the False Claims Act. This is because you or someone in your agency should have performed due diligence research to ensure that the proper information was used in the claim.
Even False Claims Act violations that result from human error can cause you to face criminal and civil charges. This means that your case could be heard in either civil or criminal court. It could even be heard in both courts. In civil court, you could be assessed with treble damages. You would pay the government three times the amount that is paid on the false claims. Additionally, you could be fined up to $11,000 per false claim.
In criminal court, you could be given a prison sentence of five years and you could also be ordered to pay fines. The amount will depend on whether you’re charged with a misdemeanor or a felony, and whether or not you’ve seen as an individual (such as a doctor or nurse) or a company (such as a health care facility or hospice center). 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.
Most qui tam cases in Miami, Florida aren’t started because the government randomly chooses to investigate. Rather, most start when former employees or a competitor takes it upon themselves to file a qui tam lawsuit. A qui tam lawsuit means that a private citizen brings a lawsuit against an individual or a business alleging that the individual or business has committed medical fraud. Qui tam means “he who sues for the king and himself” in Latin. Originally, it was meant to be used by private citizens to help protect the best interests of the government. When private citizens are successful in a qui tam lawsuit, they are given a reward of either 25 or 30 percent of the recovered funds. However, these suits are often filed by angry former employees or competitors. It is rare that the true motive behind a qui tam case is to protect the interest of the federal government.
Qui tam plaintiffs, also known as qui tam relators, file their cases in the Southern District of Florida court system. The complaints are sealed by the court clerk. Unsealed copies are provided only to the presiding judge and specific government officials. Since federal investigations can take months, extensions are routinely granted to continue the case. This gives the federal government ample time to investigate.
This investigation is important because the federal government will ultimately decide whether to reject the qui tam lawsuit in full or if it will support the case. If it is rejected in full, the case isn’t necessarily over. It just means that the government isn’t going to be involved. The suit will continue with the qui tam plaintiff. If the federal government opts to support the case, it is called intervention. If the federal government decides to support the claims, you could face additional charges such as violations of the Anti-Kickback Act and the Truth in Negotiation Act.
The federal government will contact you to begin the investigation. Your billing, corporate, financial, and communication records may be subpoenaed by the FBI, DEA, OIG, DOJ, DOD, and HHS. As soon as you’re made aware of the investigation, you should retain a health care fraud defense attorney. Your attorney can get into contact with the government entities to answer questions that you have about the investigation, and how to resolve it.
The Criminal Defense Firm’s Proven Defenses
The Criminal Defense Firm will use its experience to successfully negotiate and defend you during False Claims Act investigations. We use strategic defenses based on your individual case. The Criminal Defense Firm follows a core set of guidelines that were developed specifically for defending our clients from allegations of medical fraud.
- Early intervention. Over the years, we’ve learned that contacting federal investigators and prosecutors early in the investigative period is key to developing a defense strategy. We are able to get answers to questions that you have about whether you’re facing civil or criminal charges, the goal of the investigation, and what can be done to settle the issues. We’re generally able to get this information within just a few days.
- Passionate qui tam defense. We know that most Miami, Florida qui tam cases are started because of an angry former employee or competitor. This is why we provide a zealous qui tam defense. We will challenge the evidence presented in the lawsuit. Next, we will attack the credibility of the source. Showing the federal government that the claims levied against you are unfounded is one of the best ways that we can minimize the potential of government intervention.
- Negotiating a settlement. We can help negotiate an acceptable settlement for civil damage amounts. We’ve successfully reduced the original federal government demands to a fraction of the amount in previous cases. To date, none of our clients had to quit practicing or shut down their businesses because of a False Claims Act violation.
False Claims Act investigations and qui tam lawsuits are time-consuming. They also present a legitimate threat to your livelihood. You should take these investigations very seriously. Early intervention by The Criminal Defense Firm can successfully resolve your case. Call us now to discuss your case. Initial consultations are free of charge and totally confidential. We’re available 7 days a week. You can also contact us through our online contact form or send us an email.
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 Miami, Florida
Dr. Nick Oberheiden has represented clients in Qui Tam, False Claims Act, Medicare Fraud, Tricare Fraud, Stark Law, and anti-kickback proceedings before virtually all federal agencies including but not limited to the Office of Inspector General (OIG), the Department of Health and Human Services (HHS), the Department of Defense (DOD), the Department of Justice (DOJ), and the Department of Labor (DOL). Dr. Oberheiden is trained in negotiations by Harvard Law School and holds a Juris Doctor from the University of California, Los Angeles, as well as a Ph.D. in law.
Lynette S. Byrd is a former Assistant United States Attorney (AUSA). Clients greatly benefit from Lynette’s experience from the Department of Justice, where she prosecuted health care fraud, Anti-Kickback violations, False Claims Act, and Stark violations on behalf of the United States. Lynette has immense experience with health care law enforcement, and she regularly argues federal matters for her clients.
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. Mr. Oberheiden limits his practice to federal law.