False Claims Act Attorneys
At Candice Fields Law, PC, our seasoned attorneys have experience defending clients against allegations under the False Claims Act (FCA). With extensive experience and a deep understanding of both state and federal legal systems, we provide unparalleled legal support to individuals and corporations facing False Claims Act accusations. Our approach combines diligent legal research, strategic defense planning, and unwavering advocacy to protect your rights and reputation. To meet with a False Claims Act attorney, contact us today.
What is the False Claims Act?
The False Claims Act is a federal law that penalizes individuals and entities for defrauding governmental programs. It is one of the most powerful tools in the United States Department of Justice's arsenal to combat fraud against the government. Violations can result in significant financial penalties and damages. The Act also includes whistleblower provisions that allow private individuals to file lawsuits on behalf of the government and share in any recovered damages.
Types of False Claims Act Violations
The False Claims Act (FCA) is a federal law that aims to combat fraud against the federal government. It allows individuals to file actions on behalf of the government and share in a portion of the recovered damages. FCA violations can manifest across various industries, particularly in sectors that receive significant federal funding, such as healthcare, defense, and education. Understanding the types of False Claims Act violations is essential for compliance and legal defense. Here are some of the most common types:
1. Billing for Services Not Rendered
This violation occurs when a provider bills the government for medical services, treatments, or procedures never provided to the patient. This can include billing for appointments the patient did not attend or for medical devices not supplied.
2. Upcoding
Upcoding is the practice of billing for more expensive services or procedures than were provided or performed. In the healthcare sector, this might involve coding a routine visit as requiring a higher level of care to increase reimbursement from government healthcare programs.
3. Unbundling
Unbundling refers to billing each step of a procedure as if it were a separate procedure. This is a violation because certain procedures are supposed to be billed together at a reduced cost, rather than individually at a higher total cost.
4. Providing Medically Unnecessary Services
Submitting claims for procedures, tests, or treatments that are not medically necessary to increase revenue is another FCA violation. This not only defrauds the government but can also put patients at risk.
5. Kickbacks and Illegal Referrals
The Anti-Kickback Statute prohibits offering, paying, soliciting, or receiving anything of value to induce or reward referrals or generate Federal healthcare program business involving any item or service payable by the Federal government. Violations of this statute can also be considered violations of the False Claims Act.
6. Misrepresenting Costs or Prices
This involves falsely reporting the costs or prices of goods and services to increase reimbursement rates or to secure government contracts under false pretenses. It can include inflating costs, misrepresenting the manufacturer's price, or hiding discounts.
7. Falsifying Research or Pharmaceutical Claims
In cases involving pharmaceutical companies or research institutions, falsifying research data or results to get drugs approved or to secure government grants constitutes a violation of the FCA.
8. Failure to Comply with Contract Specifications
This type of violation occurs when a contractor knowingly fails to comply with the specifications of a government contract but claims payment for full compliance. It can include using inferior materials or skipping required testing.
9. Product Substitution
Substituting products that are inferior or not compliant with the standards required by government contracts without disclosing the substitution violates the FCA.
10. Misuse of Grant Money
Misappropriating or misusing federal grant money for purposes not outlined in the grant's terms and conditions is another form of FCA violation. This can include using grant money for personal expenses or for projects unrelated to the grant's intended purpose.
Penalties for Violating the False Claims Act
Violations of the False Claims Act (FCA) can result in severe penalties, ranging from substantial financial fines to criminal charges. These penalties are designed both to punish wrongdoing and to deter future violations. Here's an overview of the penalties associated with FCA violations, ordered from the most severe to the least impactful:
Criminal Charges
In cases where the FCA violation involves intentional fraud, defendants may face criminal charges. This is the most severe consequence of an FCA violation and can result in imprisonment in addition to financial penalties. Criminal charges are typically reserved for the most egregious cases of fraud.
Civil Penalties
For each false claim, the violator can be subject to civil penalties ranging from $11,665 to $23,331 (as of adjustments made in 2020, though these amounts are subject to periodic inflation adjustments). These penalties apply to each invoice or false claim submitted, which can quickly add up to substantial amounts.
Treble Damages
Beyond civil penalties, violators of the FCA can be ordered to pay three times the amount of damages sustained by the government due to the false claims. This is known as treble damages and can significantly increase the financial impact on the violator, making it one of the most financially burdensome consequences of an FCA violation.
Exclusion from Federal Programs
Individuals or entities found guilty of violating the FCA may be excluded from future participation in federal programs, such as Medicare and Medicaid. This can be devastating to healthcare providers and companies that rely heavily on federal healthcare programs for their revenue.
Settlements
Many FCA cases are resolved through settlements, where the accused party agrees to pay a certain amount without admitting liability. While this might seem less impactful than other penalties, settlements often involve large payments and may also include the requirement to enter into a Corporate Integrity Agreement (CIA), which imposes rigorous compliance requirements and monitoring.
Reputation Damage
Though not a legal penalty, the damage to an individual's or company's reputation following an FCA violation can have long-lasting effects. The public nature of these cases can lead to loss of business, difficulty in securing future contracts, and a tarnished brand image.
Cost of Litigation
Defending against FCA allegations can be costly, involving attorney fees, court costs, and the expense of potential settlements. Even if an entity or individual is not found liable, the financial burden of litigation can be significant.
Administrative Remedies
In addition to legal penalties, administrative remedies may be pursued, such as the recoupment of overpayments for healthcare providers. While these are generally less severe than criminal charges or civil penalties, they can still represent a significant financial impact.
The FCA is a powerful tool in the fight against fraud, waste, and abuse in federal programs. The penalties for violations reflect the serious nature of defrauding the government. Individuals and entities dealing with government contracts or federal healthcare programs must ensure compliance to avoid the severe consequences of an FCA violation.
How a False Claims Act Attorney Can Help
At Candice Fields Law, PC, we understand the complexities and challenges of facing allegations under the False Claims Act (FCA). Our dedicated team of False Claims Act attorneys is here to offer experienced legal assistance and guidance to individuals and entities accused of FCA violations. Here’s how we can help:
Early Intervention and Investigation
Our first step is often to intervene early in the investigative process. We work closely with you to understand the specifics of your case, gather necessary evidence, and engage with government investigators. Early intervention can sometimes prevent charges from being filed, minimizing legal exposure and protecting your reputation.
Comprehensive Defense Strategy
Our attorneys have a deep understanding of the False Claims Act and are skilled in developing comprehensive defense strategies tailored to the unique aspects of each case. We assess all available evidence, identify weaknesses in the government’s case, and build a strong defense to achieve the best possible outcome for our clients.
Experienced Negotiation
Many FCA cases are resolved through settlements. Our PPP loan fraud attorneys are skilled negotiators who can navigate the complex settlement process. We work to negotiate favorable terms that minimize financial impact and avoid admission of liability whenever possible. Our goal is to protect your interests while resolving the matter efficiently.
Litigation and Trial Advocacy
When a case goes to trial, you need an experienced legal team in your corner. Our False Claims Act attorneys are seasoned litigators with a proven track record of success in court. We prepare meticulously for trial, advocating forcefully on your behalf to challenge the government’s claims and present a compelling defense.
Compliance and Risk Management
Beyond defending against FCA allegations, we also assist organizations in developing and implementing effective compliance programs. This proactive approach helps prevent future violations by ensuring adherence to the complex regulations governing federal programs. We provide training, conduct audits, and offer ongoing counsel to help our clients manage risk and maintain compliance.
Personalized Attention and Support
We understand the stress and uncertainty of facing legal challenges under the False Claims Act. We offer personalized attention and support throughout the legal process, keeping you informed and involved at every step. Our client-centered approach focuses on minimizing disruption to your life and business while vigorously protecting your rights.
Facing False Claims Act Allegations?
Secure your defense with Candice Fields Law, PC. Our experienced FCA attorneys are ready to protect your rights and guide you to a favorable outcome. Act now—contact us for a consultation and start building your defense today.
False Claims Act Lawyer FAQs
What does it mean to be charged under the False Claims Act?
Being charged under the False Claims Act (FCA) means the government believes you have submitted false or fraudulent claims for payment to federal programs. This can involve billing for services not provided, upcoding, or receiving kickbacks. It's a serious situation that can lead to significant penalties and requires experienced legal defense.
I've been accused of an FCA violation. What should I do first?
If you're accused of an FCA violation, the first step is to contact an experienced False Claims Act defense lawyer. A defense lawyer with experience in FCA cases can help you understand the charges against you, advise on your rights, and formulate a defense strategy.
How can a False Claims Act defense lawyer help me?
A defense lawyer can assist you in several key areas, including investigating the claims against you, developing a strong defense strategy, negotiating with the government to potentially settle out of court, representing you in legal proceedings, and advising on compliance to avoid future accusations.
What are the potential penalties for violating the FCA?
Penalties can be severe and include treble damages (three times the loss to the government), civil penalties for each false claim, possible exclusion from future government contracts, and in some cases, criminal charges. The exact penalties will depend on the specifics of your case.
Can my FCA case be settled before it goes to trial?
Yes, many FCA cases are settled before reaching trial. An experienced FCA defense lawyer can negotiate with the government on your behalf, aiming to reach a settlement that reduces penalties and may avoid an admission of guilt.
What protections do I have if I'm falsely accused?
The FCA includes procedural safeguards to ensure fair treatment for those accused. This includes the right to legal representation, the right to present your case in court, and protections against retaliation. An FCA defense lawyer can help protect your rights throughout the process.
How long does the government have to bring an FCA case against me?
The FCA statute of limitations is generally six years from the date of the violation or three years after the government knows or should have known about the material facts, but no more than ten years after the violation. An FCA defense lawyer can advise on how these limits apply to your case.
Is it important to have a lawyer with FCA experience?
Yes, it's crucial. The False Claims Act is complex, and facing charges can be daunting. An experienced FCA defense lawyer will deeply understand the law, the legal process, and how to navigate both to your best advantage.
Can I defend myself against FCA charges?
While you have the right to defend yourself, it is highly advised against due to the complexity of FCA litigation and the severe consequences of a conviction. Hiring a skilled defense lawyer greatly increases your chances of a more favorable outcome.
