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August 24, 2020Hot off the Presses: California Further Regulates Out-of-State Adjusters in the Wake of Record-Breaking Catastrophic Losses
What Kinds of Fraud are Actionable Under the False Claims Act?
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Any information that you send us in an e-mail message should not be confidential or otherwise privileged information. Sending us an e-mail message will not make you a client of Robins Kaplan LLP. We do not accept representation until we have had an opportunity to evaluate your matter, including but not limited to an ethical evaluation of whether we are in a conflict position to represent you. Accordingly, the information you provide to us in an e-mail should not be information for which you would have an expectation of confidentiality.
If you are interested in having us represent you, you should call us so we can determine whether the matter is one for which we are willing or able to accept professional responsibility. We will not make this determination by e-mail communication. The telephone numbers and addresses for our offices are listed on this page. We reserve the right to decline any representation. We may be required to decline representation if it would create a conflict of interest with our other clients.
By accepting these terms, you are confirming that you have read and understood this important notice.
The False Claims Act covers basically any claim for payment or money owed to a federal program, except for taxes. Over the last decade, most recoveries under the False Claims Act have been for claims in health care (Medicare, Medicaid, Tricare, Federal Employee Health Benefits Program, and VA), defense spending (Department of Defense), and banking (Fannie Mae and Freddie Mac); as well as dealings with the Small Business Administration, for-profit universities, customs duties, and energy grants.
What are some examples of health care fraud?
Many different kinds of wrongdoing qualify as fraud that allows a recovery under the False Claims Act but to be actionable under the statute, the fraud must involve payments by a federal program (such as Medicare, Medicaid, Tricare, the VA, or the Federal Employee Health Benefits Program). Robins Kaplan attorneys have successfully tried health care fraud
False Claims Act cases in the following areas:
- Kickbacks (providing someone something of value in order to convince them to refer a patient)
- Ambulance transport fraud (billing for transport that wasn’t necessary, or for more miles than were actually travelled)
- “Up-coding” fraud (billing for a more expensive medical service than what was performed)
- Home health care fraud (billing for services not provided)
- Hospital fraud (for example, billing as in-patient services that should have been performed out-patient)
- Laboratory fraud (for example, giving away free services to attract more referrals or billing for unnecessary tests)
- Long term care and skilled nursing facilities fraud (for example, billing for rehabilitation services that were either not provided or not necessary)
- Pharmaceutical fraud (for example, marketing a drug for an unapproved – “off-label” – use, or paying doctors to prescribe a drug)
- “Stark Law” violations (referring patients for services where the referring physician or practice has a financial interest)
If you suspect that health care fraud is being committed and wish to take action, we can help.
For a confidential case evaluation, please contact us at 1.888.563.1378 (toll-free), or complete our confidential case evaluation form above. We handle cases in all 50 states.
RELATED PROFESSIONALS
Timothy Q. Purdon
Partner
Co-Chair, American Indian Law and Policy Group;
Co-Chair, Government and Internal Investigations Group;
Co-Chair, Diversity Committee
Brendan V. Johnson
Partner
Co-Chair, American Indian Law and Policy Group;
Co-Chair, Government and Internal Investigations Group
If you are interested in having us represent you, you should call us so we can determine whether the matter is one for which we are willing or able to accept professional responsibility. We will not make this determination by e-mail communication. The telephone numbers and addresses for our offices are listed on this page. We reserve the right to decline any representation. We may be required to decline representation if it would create a conflict of interest with our other clients.
By accepting these terms, you are confirming that you have read and understood this important notice.