False Claims Archives - National Whistleblower & Government Fraud Settlement Attorney

What Are the False Claims Act Statistics When It Comes to Prosecution?

Posted on November 2, 2016 by Mike Bothwell

Why is it important to look at the False Claims Act statistics for prosecution? Many things in life are a gamble. Every good gambler knows you need to play the odds if you’re going to have a chance of winning. When you are considering whether you should report fraud against the government, you’re making a big decision. You should never enter into any lawsuit without careful consideration, but in the case of whistleblowing, a lot of things are at stake.

One of the greatest considerations is the magnitude of the crime. False Claims Act cases are not small matters. Fraud committed against the government by an organization is often on a large scale. For many people, the difficulty in turning a blind eye increases in direct proportion to the size of the crime.

On the other hand, the risk of personal harm is also high. There are laws to protect a whistleblower from retaliation in his job, but that does not mean your employer won’t attempt to go around these protections. After all, the same company chose to commit fraud, perhaps to the tune of millions of dollars. The law will make sure you get your job back and will compensate you for damages or return you to your previous status with your employer. That doesn’t mean you won’t suffer harm while things work through the court process.

Because the consequences are so high, it isn’t unusual to wonder if it’s all worth it. Looking at the statistics of prior False Claims Act cases can help you make your decision. The most recent False Claims Act statistics can be found easily by visiting The United States Department of Justice and conducting a search with the keywords “False Claims Act” and “Statistics.” They lay everything out there for anyone to see. All you need to do is look it up.

According to the information published by the United States DOJ, at the end of December 2015, the government had recovered $26.4 billion in judgments and settlements from civil cases since 2009. Of those cases, over $2.2 billion was awarded to the Whistleblowers.

What Do the False Claims Act Statistics Mean for Whistleblowers?

The law states that the whistleblower, or relator, is entitled to 15% to 25% of whatever amount the government recovers. The national average percentage recovered by whistleblowers is 16% of the government’s take. Some clients of the Bothwell Law Group have received between 25% and 30%. In one particular case, the Bothwell Law Group achieved a settlement of $1.8 million.

In 2015 alone, the Department of Justice received over $3.5 billion in settlements with $1.9 billion of this coming from healthcare cases. These healthcare fraud cases involved the negligent care of patients and clients. They also included kickbacks the hospitals and medical care providers received for using particular healthcare products. Some of the people prosecuted were offending as individuals, and some were companies. All of these cases involved government funding, which is the criteria for a False Claims Act violation.

The statistics that the Department of Justice collects clearly show the success of the False Claims Act and the 1986 amendment. The transparency is a positive outcome for both the government and the whistleblowers. Whistleblowers receive a financial reward as well as the satisfaction of knowing they have helped stop the illegal and immoral activity.

Which Types of Fraud Are Convicted Most Often, According to False Claims Act Statistics?

Achieving prosecution under the False Claims Act is a complicated and drawn-out procedure. You need to be certain you are working with a competent and experienced attorney with a focus on whistleblower cases. Most attorneys working with the False Claims Act have particular areas of fraud on which they concentrate. These areas can include:

● Medical Fraud, Overbilling and Healthcare Scams
● Hospice Care and Nursing Home Fraud
● Mortgage Fraud
● State Education Fraud
● Government Grant and Program Fraud
● Dental Fraud
● Contractor Fraud
● Intellectual Property Fraud

What Do False Claims Act Statistics Predict for the Future?

No one has a crystal ball to predict what the future holds for filings under the False Claims Act. However, we do know that whistleblowers are an important part of the prosecution process. In 2012, over 70% of successful prosecutions came from reports from individuals. A thorough reading of the statistics on the DOJ’s website shows that this trend will continue as people become more aware of fraud and more willing to report it.

Do you have more questions about False Claims Act statistics for prosecution? Contact the skilled False Claims Act attorneys at Bothwell Law Group by calling 770.643.1606 today.

The Single Most Important Thing to Know about State False Claims Acts

Posted on September 12, 2016September 6, 2016 by Mike Bothwell

State False Claims Acts vary from state to state. It’s critical to have an attorney who knows how they work to help you get the proper rewards. Without this attorney, you may feel very overwhelmed and maybe even a little lost.

Most things in life have lessons to learn and important things to know to do them in the best possible way. Babies are like that. When you bring that tiny little bundle home for the first time, it’s easy to be panic stricken over all the important things you don’t know.

State False Claims Acts are a lot like the first day with your new baby. There are a few critical things to remember. Your state’s False Claims Acts attorney will handle the rest.

Different states’ False Claims Acts are going to be different. You need to understand the most important factors stay the same. Having an attorney who knows those important factors will help you build a strong case against the fraudulent crime committed against your state government.

What Are State False Claims Acts?

The most important thing to know about state False Claims Act cases is every state has different types of False Claims Act cases they handle. Not every state handles every kind of False Claims Act fraud.

State False Claims Acts laws were created to bring suit on behalf of state governments when fraud takes place. In response, the government allows the whistleblower part of the money recovered in court, called the reward.

At first, whistleblower or False Claims Act claims could only be filed on behalf of the federal government. Unfortunately, fraud is also committed against state agencies as well. Now people who notify their state government of fraud, known as relators, are eligible for rewards and protections as well.

Why Do I Need a State False Claims Acts Attorney?

False Claims Act cases are complicated. They must follow an exact strategy, or the government will not advocate for the case. Your chance of a successful lawsuit is increased mightily when the government steps in. Stepping in or intervening means the state decides a crime is happening. An experienced attorney knows how to structure the complaint to persuade the government to take the lead.

When state funds are stolen through fraud, your attorney needs to know how the specifics of your state laws function. Not every state has False Claims Act laws. In the states that do have them, the details can vary a lot. One of the biggest differences between states is many of them only allow False Claims Act suits for particular types of fraud.

Why Are the States Involved in False Claims Acts?

Fraudulent claims against Medicaid are some of the most common types of False Claims Acts against states. Almost every state has provision for these kinds of suits. State funding for Medicaid comes from the federal government. Because of this transfer of funding, states need to take on the responsibility to investigate fraud.

In 2006, the Deficit Reduction Act was enacted. This act contained incentives for states to create anti-fraud legislation fashioned after the federal False Claims Act. Although many states created legislation, it is usually not modeled on the federal laws.

State administrators are the primary party responsible for preventing fraud against Medicaid. But, unless their state laws changed to follow the federal laws, they are no longer eligible for any financial incentives. It isn’t a new tradition for the state to oversee fraud. The federal government should be in an overseer position and has been for decades. The federal government encourages states to work as hard as possible to search out fraud. They offer financial incentives to this end.

Unfortunately, the instances of fraud are not always readily apparent due to the sheer numbers of Medicaid cases requiring monitoring. Because of this, frauds against state Medicaid take place unfettered. By bringing the information to a state False Claims Act attorney, you can prepare a case for your state Attorney General. If the state intervenes on your behalf, they will conduct the anonymous investigation and the court action. You will receive a portion of any money recovered.

At Bothwell Law Group, we have lawyers trained and experienced in state False Claims Act cases. We will sit down with you and discuss the potential of your case. Our attorneys will direct you toward the type of evidence needed to file a case. They will provide support every step of the way. You’ll find your fears will fade as our attorneys come alongside and handle the details for you.

The law says your employer cannot retaliate against you. Our attorneys will help you protect your rights. Contact our legal team at Bothwell Law Group online today to learn more about State False Claims Acts.

What Motivates a Federal Whistleblower to Blow the Whistle on Defense Contract Fraud?

Posted on February 8, 2016February 4, 2016 by Mike Bothwell

You’ve probably heard stories about someone in the defense industry becoming a federal whistleblower. The person came across fraud of some sort, and then took action to turn in the perpetrators to the government. The trial was long and arduous, taking months, or even years, to complete.

Doing so earned them the title of “whistleblower” and possibly blacklisted them in the industry for the rest of their lives. So why would someone decide to go through with it?

Well, there are a number of reasons you might consider it, but here are a few of the most common:

Is Whistleblowing All about the Money?

With the U.S. spending over $500 billion every year on national defense, the sheer volume of transactions is staggering. This makes oversight phenomenally difficult, and the opportunity for fraud quite high. Even if only 5% of the industry was fraudulent, that is still a $25 billion slice of the pie.

However, the government understands they have a weak spot, and so they implemented the False Claims Act. Among other things, the Act has a provision for rewarding anyone who turns in a company perpetrating fraud. Depending on their role, the size, scope, and impact, the person blowing the whistle stands to receive as much as 30% of the funds recovered.

True, the average amount runs about 16%; but if the fraud is significant enough, it can still mean a huge payday. The whistleblower reward record tops $100 million. That’s more than most lottery jackpots!

Reporting Fraud Is a Patriotic Duty

Sometimes the type of fraud being exposed involves the provision of products and services which don’t meet the agreed upon standards. This was the reason the False Claims Act, also known as the Lincoln Act, was originally put in place during the Civil War.

Contractors agreed to provide items like boots, horses, and munitions of a particular quality for a set price. Instead, they supplied sub-par products (think: weevil-filled flour, boots with holes in the soles, and lame horses near death). The cost of these provisions was much less than what they made on the contract, and the fraudsters pocketed the remaining funds. Needless to say, this led to countless lives lost, and a massive deterioration in morale.

Modern day equivalents could be something like inferior body armor. While it may look fine on the surface, and withstand a single bullet strike, multiple bullet strikes would compromise the protective integrity and lead to significant trauma or death.

Ethical or Moral Objections Lead to Whistleblowing

At the end of the day, some people’s conscience just cannot be quieted. Similar in ways to patriotic duty, the mere fact of KNOWING something is wrong or illegal is enough to drive certain people to take action. The money is a nice bonus but, for them, it’s more about a clear line between right and wrong.

Interested in Learning More About the False Claims Act and Whistleblowing?

Find out what you need to know about becoming a federal whistleblower by calling our legal team at Bothwell Law Group at 770.643.1606 now

What is a False Claim?

Posted on October 15, 2015December 7, 2015 by Mike Bothwell

In essence, a false claim is any knowing claim or statement that is false and made for the purpose of defrauding another, or conspiring with another to do so. The False Claims Act (31 U.S. C. secs 3729-3733), or “Lincoln Law” is a federal statute that imposes liability on those who attempt to defraud governmental programs. These cases arise both in the pursuit of payment from governmental programs and the avoidance of payment rightfully owed to governmental programs.

What is a False Claim: Medicare and Medicaid

These claims arise in a surprisingly broad array of scenarios, many in the Medicare and Medicaid area, including fraudulent health care billing, performing inappropriate or unnecessary medical procedures, false billing of any kind for services not rendered or goods not delivered, misrepresentations regarding the quality of goods or services in billing, duplicate or false billing, or misrepresentations regarding actual costs in reimbursement claims. In all cases, in order to be held liable under the statute, the person must have submitted the false claim with knowledge of its falsity. This requirement includes: (1) actual knowledge, (2) deliberate ignorance of the truth or falsity of the information, or (3) reckless disregard of the truth or falsity of the information.

What is a False Claim: Anti-Kickback and the Stark Law

Kickbacks are also a violation of the False Claims Act. These kickbacks often involve either a hidden payment made in exchange for patient referrals, or another non-cash payment to a physician for patient referrals. These non-cash kickbacks often violate the Stark Law.

Physician self-referral is a practice in which an attorney refers a patient to a medical facility in which the physician or a member of the physician’s family has a financial interest. This poses the potential for a conflict of interest. The Stark Law is meant to prohibit this potential conflict from arising by prohibiting this self-referral. The Stark Law is a complex set of federal regulations. There are exceptions to the self-referral ban, but penalties for its violation are steep. Attorney assistance is required to determine if a violation has occurred or if the physician falls within one of the exceptions. Violation of the Stark Law is also a violation of the False Claims Act. The Stark Law (42 U.S.C. sec 1395 nn), or Physician Self-Referral Law.

Damages under the False Claims Act are substantial. For each false claim submitted, a penalty is assessed at between $5,500 and $11,000. Additionally, government’s actual damages are trebled. Damages calculations vary with the type of false claims made.

The False Claims Act allows private persons to file suit for its violation. This type of suit is called a “qui tam” action and the person bringing the suit is called a “relator.” These whistleblowers are an integral part of the False Claims Act and are rewarded and protected under the Act.