Attorney Gregory A. Hall has been handling claims in state and federal court since 1995.  False Claims Act Attorney Gregory A. Hall has gained significant insight into workings of several federal government agencies, having represented many federal employees.  Attorney Hall invites anyone with a potential false claims act claim to contact him about their claim.

Overview of the False Claims Act

The False Claims Act allows U.S. taxpayers to recover the billions of dollars stolen through fraud by U.S. government contractors every year.  Under the False Claims Act, 31 U.S.C. §§ 3729-3733, those who knowingly submit, or cause another person or entity to submit, false claims for payment of government funds are liable for three times the government’s damages plus civil penalties of $5,500 to $11,000 per false claim.  However, the False Claims Act does not cover tax fraud.  Tax fraud claims are handled by the IRS pursuant to the IRS Code.
In 1986, in response to the recognition that U.S. Treasury was losing its fight against rampant fraud, Congress rejuvenated a Civil War-era law—the False Claims Act.  The 1986 amendments strengthened the False Claims Act’s qui tam provisions, creating incentives for private citizens with evidence of fraud to commit their time and resources to supplement the Government’s efforts. By doing so, Congress put into play a powerful public-private partnership for uncovering fraud against the federal government and obtaining some recovery for American taxpayers.

What is a Qui Tam Action?

The False Claims Act contains qui tam, or whistleblower, provisions. Qui tam is a mechanism that allows citizens with strong evidence of fraud against government contracts and programs to sue, on behalf of the government,0Ain order to recover the stolen funds.  In compensation for the risk and effort of filing a qui tam case, the citizen whistleblower or "relator" may be awarded a portion of the funds recovered, typically between 15 and 25 percent.  A qui tam suit initially remains under seal for at least 60 days during which the U.S. Attorney’s Office considers the case to decide whether to join the action.

Who Does the Law Apply To?

In general, the False Claims Act covers fraud involving any federally funded contract or program, with the exception of tax fraud.  While many qui tam actions have concerned contractors with Department of Defense, recently most qui tam actions target Medicare fraud and fraud against other federally funded health care programs.  A broad array of scenarios can constitute FCA violations, some examples of which include:
A grant recipient charges the Government for costs not related to the grant.
A contractor falsifies test results or other information regarding the quality or cost of products it sells to the Government.
A health care provider bills Medicare for services that were not performed or were unnecessary.
Billing for marketing, lobbying or other non-contract related corporate activities.
Billing for goods and services that were never delivered or rendered.
Submitting false service records or samples in order to show better-than-actual performance.
Presenting broken or untested equipment as operational and tested.
Performing inappropriate or unnecessary medical proced ures in order to increase Medicare reimbursement.
Billing for work or tests not performed.
Billing for premium equipment but actually providing inferior equipment.
Automatically running a lab test whenever the results of some other test fall within a certain range, even though the second test was not specifically requested.
Defective testing - Certifying that something has passed a test, when in fact it has not.
"Lick and stick" prescription rebate fraud and "marketing the spread" prescription fraud, both of which involve lying to the government about the true wholesale price of prescription drugs.
Unbundling - Using multiple billing codes instead of one billing code for a drug panel test in order to increase remuneration.
Bundling -- Billing more for a panel of tests when a single test was asked for.
Double billing - Charging more than once for the same goods or service.
Upcoding - Inflating bills by using diagnosis billing codes that suggest a more expensive illness or treatment.
Upcoding employee work: Billing at doctor rates for work that was actually conducted by a nurse or resident intern.
Billing for brand -- Billing for brand-named drugs when generic drugs are actually provided.
Phantom employees and doctored time slips: Charging for employees that were not actually on the20job, or billing for made-up hours in order to maximize reimbursements.
Yield burning -- skimming off the profits from the sale of municipal bonds.
Falsifying natural resource production records -- Pumping, mining or harvesting more natural resources from public lands that is actually reported to the government.
Being over-paid by the government for sale of a good or service, and then not reporting that overpayment.
Misrepresenting the value of imported goods or their country of origin for tariff purposes.
False certification that a contract falls within certain guidelines (i.e. the contractor is a minority or veteran).
Billing in order to increase revenue instead of billing to reflect actual work performed.
Failing to report known product defects in order to be able to continue to sell or bill the government for the product.
Billing for research that was never conducted; falsifying research data that was paid for by the U.S. government.
Winning a contract through kickbacks or bribes.
Prescribing a medicine or recommending a type of treatment or diagnosis regimen in order to win kickbacks from hospitals, labs or pharmaceutical companies.
Billing for unlicensed or unapproved drugs.
Forging physician signatures when such signatures are required for reimbursement from Medicare or Medicaid.

Limits on the False Claims Act

The False Claims Act does not cover all types of fraud, and the capacity to bring a claim is restricted by the realities of litigation and the judicial system:

For a civil case to be filed, the fraud has to reach a certain size, otherwise it is not worth the risk to the relator for his or her career to file suit, nor is it worth it for a law firm to risk the loss of the enormous time and expense that a False Claims Act entails.

A defendant in a False Claims Act has to be solvent and have deep pockets.  Many of the smaller companies that may be defrauding the government can declare bankruptcy if faced with the triple damages that can be levied under the False Claims Act, thereby becoming “judgment proof”.

A false claim act lawyer will carefully screen a False Claims Act to ensure there is sufficient evidence to proceed.  Not only can a firm be out time and money, but if the U.S. Attorney’s Office declines to take the case and the whistleblower proceeds on his or her own, then the individual whistleblower can end up having to pay the defendant’s attorney's fees and costs if the court finds that the claim was frivolous or brought primarily for purposes of harassment.

State Law False Claims Acts

In addition to the Federal False Claims Act, several states have their own statutes governing frauds perpetrated against state governments. States with False Claims Acts include: California, Delaware, the District of Columbia, Florida, Hawaii, Illinois, Louisiana, Massachusetts, Nevada, New Mexico, Tennessee, Texas, and Virginia.
If you believe you may have a false claims act claim, you should contact False Claims Act Attorney Gregory A. Hall at www.afalseclaimsactlawyer.com

For a free telephone consultation, contact:
 
Gregory A. Hall
A Colorado False Claims Act Attorney
3570 E. 12th Avenue, Suite 200
Denver, CO 80206
Phone: 303-320-0584
Email: gregory@federallaw.com