False Claims Act Violations Archives - National Whistleblower & Government Fraud Settlement Attorney

What Types of Acts Are Covered by the False Claims Act?

Posted on April 17, 2017June 5, 2017 by Mike Bothwell

Knowing which types of acts are covered by the False Claims Act is important. It can determine whether a whistleblower can take advantage of reward and protection provisions under the False Claims Act. While most acts that fall under the False Claims Act revolve around the fraudulent taking of money from the US government, not every instance of fraud will result in a False Claims Act violation.

What Does the False Claims Act Prohibit?

In general, the False Claims Act will outlaw an activity that results in an individual or organization improperly obtaining money or property from the US government. An individual or organization may do this by submitting false documents to the government, obtaining government property from someone who is not allowed to sell or distribute the property or by simply planning with another person or entity to defraud the government.

To help the US government fight fraud, the False Claims Act contains a qui tam provision which allows non-government individuals, called relators, to bring claims on the government’s behalf. The purpose of bringing these claims is to impose penalties on the wrongdoer and recover money lost as a result of the fraud.

Because individuals who act as whistleblowers are at extreme risk of suffering from retaliation, the False Claims Act contains an anti-retaliation provision. This provision prohibits an employer from discharging, demoting, harassing, threatening or in any way discriminating against an employee, contractor or agent who exercises his or her rights under the False Claims Act, including acting as a whistleblower. If the employee, contractor or agent can prove retaliation, they may receive reinstatement (if applicable), double the back pay, interest, special damages and reasonable attorneys’ fees.

What Types of Acts Are Not Covered by the False Claims Act?

There are three main exceptions to the qui tam provision of the False Claims Act. Qui tam actions cannot come from a current or former member of the armed forces against another member of the armed forces when the alleged fraud occurred during the individual’s service in the armed forces.

Another exception exists when a qui tam action is against a member of Congress, the judiciary or a senior executive branch official. In these situations, the qui tam action cannot proceed if the evidence used in the qui tam lawsuit uses information known to the US government when the qui tam action began.

The final primary exception is tax fraud. Instances of tax fraud or any other improper activities that would fall under the Internal Revenue Code of 1986 are not subject to the False Claims Act.

There are also several defenses to certain parts of the False Claims Act that might normally result in liability. The first defense is the lack of knowledge defense. If an alleged wrongdoer didn’t know nor had no reason to know it was committing fraud against the government, they cannot be liable under the False Claims Act.

Another defense is that the US government already knew about the alleged fraud but chose not to take action on it. For example, a contractor knowingly does not conduct testing using methods as required by its contract with the US government. If the government is aware that different testing methods are in place but approves the different testing methods anyway, there can be no False Claims Act violation for knowingly failing to abide by the contract.

What Specific Examples of Acts Are Covered by the False Claims Act?

The False Claims Act covers a broad array of prohibited activities, including:

● Engaging in improper conduct to hold onto an overpayment by the US government.
● Asking the government to pay something the individual or wrongdoer knows it is not entitled to have.
● Providing defective products or services to the government. The False Claims Act will apply even if the seller doesn’t knowingly provide defective products or services, as long as the seller should have known the product or service was defective.
● Planning with others to violate the False Claims Act.
● Purchasing US government property from a government officer or employee that is not allowed to sell the property.
● An employer punishing an employee, agent or contractor for reporting possible False Claims Act violations. Anything significantly detrimental the employer does to the employee, agent or contractor for exercising rights under the False Claims Act will qualify as retaliation. This includes firing, demotions, pay cuts and harassment.

Need More Information?

If you’ve still got questions about what specific types of acts are covered by the False Claims Act, don’t hesitate to contact the Bothwell Law Group.

What Are the Activities Covered by the False Claims Act?

Posted on April 10, 2017April 8, 2017 by Mike Bothwell

Activities covered by the False Claims Act include a variety of actions where an individual or organization can take money for themselves that otherwise belongs to the US government. We will provide an overview of the types of activities that typically fall under the False Claims Act.

Activities Specifically Covered by the False Claims Act

The False Claims Act sets out seven specific prohibited activities. Any violation of these activities can result in liability of the wrongdoer. The prohibited activities, as well as examples of each, are below:

● “Knowingly presents, or causes to be presented, a false or fraudulent claim for payment or approval.” An example would be a construction contractor submitting an invoice for repairs made to a government building, all while knowing the invoice is incorrect because it lists work that was never actually done.

● “Knowingly makes, uses, or causes to be made or used, a false record or statement material to a false or fraudulent claim.” Consider a health care company reimbursed by the US government for each medical test it provides to soldiers during basic training. To show reimbursement costs, the health care company submits a document showing that each test cost $50 when it really only cost $10.

● “Has possession, custody, or control of property or money used, or to be used, by the Government and knowingly delivers, or causes to be delivered, less than all of that money or property.” This could occur if a shipping company should deliver 100,000 doses of morphine to troops overseas, but only delivers 95,000 doses and keeps 5,000 doses for itself, perhaps to sell on the international black market.

● “Is authorized to make or deliver a document certifying receipt of property used, or to be used, by the Government and, intending to defraud the Government, makes or delivers the receipt without completely knowing that the information on the receipt is true.” This could occur when a defense contractor receives a shipment of raw materials for building a ship. The contractor certifies the receipt showing the delivery of the raw materials is correct without first confirming that it contains all the raw materials detailed in the invoice.

● “Knowingly buys, or receives as a pledge of an obligation or debt, public property from an officer or employee of the Government, or a member of the Armed Forces, who lawfully may not sell or pledge property.” An example might include a hunting store buying military surplus gear and equipment from an enlisted soldier, but the hunting store knows the soldier stole the items from a military warehouse.

● “Knowingly makes, uses, or causes to be made or used, a false record or statement material to an obligation to pay or transmit money or property to the Government, or knowingly conceals or knowingly and improperly avoids or decreases an obligation to pay or transmit money or property to the Government.” An example involves a hospital that receives payments from the US government for treating a certain number of patients throughout the year. But at the end of the year, the hospital submits false documents claiming the cost to treat those patients was more than expected (when it was really less than expected) to avoid submitting a refund check to the government for overpayments received.

● “Conspires to commit a violation of subparagraph (A), (B), (D), (E), (F), or (G).” This means creating an agreement or plan with another to commit one of the above-listed activities prohibited by the False Claims Act.

Penalties for Engaging in Activities Covered by the False Claims Act

The penalties for violating the False Claims Act depend on the number of false claims submitted to the US government. The penalty for each violation ranges between $5,500 and $11,000. This amount changes periodically with inflation. Additionally, the individual or organization that violated the False Claims Act can be liable for up to three times the actual damages suffered by the US government.

The calculation of penalties means many small violations of the False Claims Act can sometimes result in a bigger penalty that a few large violations. This is one reason why activities covered by the False Claims Act violations in the healthcare setting often result in some of the larger penalties imposed on violators.

Wondering What Constitutes a Violation of the False Claims Act?

To learn more about activities covered by the False Claims Act, you should contact the Bothwell Law Group online and set up a time to discuss any questions you may have about the False Claims Act. We are here to help you get the information you need.

Examples of False Claims Act Violations

Posted on November 23, 2016November 18, 2016 by Mike Bothwell

Examples of False Claims Act violations show the penalties are enormous. But do examples do us any good? It depends on the situation. Many times people learn far better by example than anything else. When you are trying to learn the tango, watching a couple dance with passion teaches more than any book. But when it comes to fraud violations, the examples are frightening.

The False Claims Act exists to punish people who commit fraud against the government. This fraud exists when companies bill the government for services that didn’t take place or overcharge for materials. Billing for services not delivered, overcharging for material goods, failing to provide information related to products or services and charging for skilled professionals who did not perform the work are all examples violations.

Although the law has existed since the Civil War days, Congress made amendments in 1986. The changes allow ordinary citizens to file complaints on behalf of the government. These citizens are the whistleblowers and can receive significant rewards.

Whistleblowers usually work for the company they report for fraud. The False Claims Act protects the whistleblower from retaliation by that company. Whistleblowers that make a complaint of fraud might experience harassment at work. Employers can deny benefits or promotions. Whistleblowers can even lose their jobs. The False Claims Act makes those actions illegal. It also provides a financial reward for whistleblowers.

What Are the Most Common Examples of False Claims Act Violations?

● Most False Claims Act violations are in the healthcare and medical industries. Examples include people who lie to Medicare or Medicaid, facilities that bill for services they did not provide, or those that inflate the cost of the services they did get. They may even lie about who is providing services. The company bills the government for skilled professionals but uses non-professionals instead.

● Drug companies can often be huge offenders of False Claims Act violations. A good example is company salespeople that offer incentives to doctors. Incentives include kickbacks and gifts to the doctors in exchange for using the company’s drugs. Kickbacks can include elaborate vacations and other perks.

● Dental fraud is another example. Dentists claim payments for services they have not completed. For example, a hygienist performs a teeth cleaning, but the bill indicates the dentist did the work and charged his rate.

● More serious examples of healthcare fraud can involve nursing home care or hospice care. The administration may charge for care not given or unnecessary care. The company charges the government for procedures and tests, even though they did not perform the work. Hospice owners may provide care to people who do not need hospice level care.

What Are the Different Types of Violations that the False Claims Act Covers?

Medical and healthcare issues are the most common breaches of the False Claims Act. But there are other violations as well. Here are some examples of False Claim Act Violations:

● Scams that offer free grants for education
● Construction companies working on state highways claim for materials not used
● Business kickbacks or rewards
● Claiming unused materials or labor from defense forces
● Giving untrue information when applying for a government grant or program
● Using lower quality materials than contracted and billed for
● Giving false information to the Department of Veteran Affairs
● Government staff claiming pay for hours that they did not work
● Buying or taking property that belongs to the government

The False Claims Act protects whistleblowers from retaliation by their employers. Examples of retaliation include people losing their jobs because they made complaints, denial of promotions, or not allowing sick days. In addition, whistleblowers might have trouble getting work somewhere else. The company might spread rumors about the whistleblower’s quality of work. They may have them blackballed throughout their industry. All these are violations of the False Claims Act.

What Should You Do If Your Company Is Violating the False Claims Act?

You should consult an attorney experienced in violations of the False Claims Act. They will be able to tell you if your company is breaking the law and committing fraud. They can show you several examples of False Claims Act violations resulting in prosecution. They will also know how to protect you against any retaliation by your employer.

You must report any violations of the False Claims Act that you see. Your attorney will protect you from retaliation. If your allegations result in a conviction, you may receive a huge reward. Contact the skilled False Claims Act attorneys at Bothwell Law Group by calling 770.643.1606 today. We will sit down with you and discuss examples of False Claims Act violations, so you can move forward with confidence.

How Are False Claims Act Violations Handled by the Court System?

Posted on September 19, 2016September 6, 2016 by Mike Bothwell

The idea of filing a case against False Claims Act violations can be pretty intimidating. Worrying about retaliation on the job is frightening. Even though the law protects against retaliation such as job loss or losing a promotion, the fear is real. Retaliation can take place, and you need the law to assert your rights and reverse the discrimination.

One concern can be that you don’t yet know what happens in court in a False Claims Act violation. The court can always be scary if you aren’t used to it. Having a trained, experienced attorney at your side will help. Understanding the process beforehand will also help. It’s just like when you bake a cake. You need the proper ingredients, the order of the process, and knowledge of the waiting time while it bakes. False Claims Act violations are much the same in the process.

Will My False Claims Act Violation Go to Court?

The first step in a False Claims Act is to visit with an attorney with experience in this type of lawsuit. An attorney can tell you exactly what kind of evidence to bring to court. She will tell you how you can document your proof and keep it safe. She can discuss how you can determine if anyone else in the company is friendly to the case. There are many details, but a qualified attorney who has been down this road before knows what is necessary for the government to step in the case.

Once you have the proofs you need, you and your attorney will bring the matter to the Department of Justice. You must be the first person, or original source, to have brought the case to the government. The suit is called a qui tam suit. Qui tam means, “on behalf of the king.” The lawsuit may be brought on a federal level or a state level. It will depend on the state laws where the fraud takes place. When the proofs are brought in, the DOJ will examine the case and then investigate.

What If the Government Intervenes on Your False Claims Act Violations Case?

The government has an initial time frame of 60 days to investigate the company accused of fraud. The case is under seal, which means no one knows except you and the government. The company will not know there is an investigation. You can stay anonymous. If they decide to take the case, they take over and handle it from there. You are known as the relator. If the government wins, your reward is 15-25% of the amount recovered. This award can add up to millions of dollars.

The government can decide on a settlement that you may not agree with, but once they have intervened, you no longer have any say in the matter. The only time you have an option is if the government decides to opt out of the case and does not intervene.

What If the Government Opts out of the False Claims Act Violations Case?

If the DOJ doesn’t intervene, you can decide to continue the case on your own. It is critical to have an attorney who is well versed in False Claims Act cases at this point in the case. If you won, you would be entitled to up to 30% of the government’s award.

How Do I Know What Attorney I Should Use for False Claims Act Violations?

Like every lawsuit, you should find an attorney who is knowledgeable about qui tam cases. Choose a lawyer who has experience fighting for and winning False Claims Act violations. Make sure your attorney is someone you feel comfortable with and trust.

There can be anxiety and even fear involved in whistleblowing cases. Although your employer cannot legally retaliate against you, it doesn’t mean they won’t try. You want a False Claims Act attorney you can count on to make sure your rights are not violated at work. Harassment can be a large part of your experience, so you need to know you have someone you can rely on to get you through it.

Not everyone experiences trouble at work by bringing a suit forward, especially if the government intervenes and handles things. It’s important to be prepared, however, in case things shift against you. Just because your employer has no legal standing to fire you doesn’t mean they won’t try to get away with it.

When you’re looking for experienced attorneys who can walk you through False Claims Act violation case, look to Bothwell Law Group. We’ll walk you through the entire process and do our best to win your reward. To learn more about False Claims Act violations, contact Bothwell Law Group online today.

Top 3 Examples of False Claims Act Violations and Penalties

Posted on July 11, 2016July 5, 2016 by Mike Bothwell

If you are seeking information about False Claims Act Violations, it will help to have some real life examples about these violations and penalties. Before we get into those, let’s get a basic understanding of what the False Claims Act is:

The Act, also known as the Lincoln Law, was created in 1863 under Abraham Lincoln’s administration, to expose fraud and profiteering during the Civil War.
It allowed people to expose others who made a false claim against the government.
The Act provided protection from retaliation actions such as job loss or other damages.
In 1989, the Qui Tam Law was added, allowing private citizens to sue on behalf of the US government, keeping a percentage (usually 15-30%) of the recovered money for themselves.

How Are False Claims Act Violations Investigated?

The Qui Tam Law allows for a private citizen to bring evidence of a violation to the government, to request they investigate the allegation and potentially join the lawsuit. The Qui Tam is a civil suit. The investigation is confidential. Not even the person or organization under investigation is informed of the probe.

This confidentiality allows the US Justice Department to investigate the allegations with no harm or repercussions to either party. Once the inquiry is complete, the government decides if they will intervene. If the federal government chooses not to go forward with the action, the private citizen (and their attorney) may continue on their own. The chance of success is much higher when the government is a party to the lawsuit.

Who Are the Top False Claims Act Violators?

Qui Tam Law is used to bring some of the violators to justice, including Medicare and Medicaid Fraud, prescription drug fraud, and defense contractor fraud. These three areas commit the most violations of the False Claims Act. In fact, of the highest paid settlements on record, nine of the top ten involve the health care or prescription drug industries.

For the fiscal year ending September 2015, the top violator by far was the healthcare industry, accounting for nearly half of the $3.5 billion recovered in False Claims Act violations. Charges included inadequate or unnecessary medical procedures and treatments, kickbacks to medical providers and overcharging for Medicare/Medicaid programs. The government recovered $1.9 billion in these health care violations.

Some of the largest violations occur in the area of prescription drugs. The FDA authorizes all prescription drugs for specific uses and conditions. A doctor may make a decision to use a drug for a different condition than its original use. This prescribing is known as an off-label use of the medication and does not violate any law.

However, the drug manufacturer may not promote the drug for an off-label use. Doing so is a violation of the False Claims Act. Any kickback or benefit offered to a doctor, by a drug manufacturer is considered evidence of the breach.

Drug manufacturers are also in violation if healthcare providers receive kickbacks for prescribing certain drugs. While providing samples or referring patients can be done, doing so to provide a payback for prescribing certain drugs is fraud and is provided for under the False Claims Act and Qui Tam Law.

Other top offenders include government contract workers. Cases of government contractors who fail to fulfill the requirements of the contract yet bill for the fulfillment of the deal are standard. These violations can include substituting lower quality materials than what is required or failing to perform quality assurance checks.

Government contract violations include the implicit agreement to provide what the contract states, without substitution. Even if the substitution is of equal quality, it is not allowed and is a violation.

Contract violations include actions such as inflating bids with false information, awarding bids based on falsified information, and failing to comply with contracts available only to minority-owned businesses, female-owned businesses, or small businesses.

How Large Can the Penalties Be for False Claims Act Violations?

Penalties for False Claim Act violations can be astronomical, with the largest on record against pharmaceutical giant GlaxoSmithKline who paid out $3 billion in civil and criminal penalties. Some of this money was then passed onto the whistleblowers in each case. There were several cases involved that included the company pleading guilty to falsifying and fabricating research, bribing doctors with luxury vacations and of providing marketing kits packed with unproven claims, specifically regarding nine different drugs.

False Claims Act violations come from employees working for and with the violators. They have first-hand knowledge. One of the most important reasons to report false claims is for your own protection. All investigations, under the Qui Tam Law, are kept sealed. If your place of employment is under scrutiny, your position in the company could make you complicit. By coming forward with the information, you are protecting yourself from being inadvertently charged as part of the fraud.

If you think you have information regarding a False Claims Act violation, the best first step is to call an attorney who is informed and experienced in Qui Tam Law cases. These laws are influx on a regular basis, so choose lawyers who committed and dedicated to this type of work and up-to-date on any changes. Call (770) 643-1606 to find out more about False Claims Act violations by contacting Bothwell Law Group online.