Must Know Information about the False Claims Act

The FCA, or the False Claims Act of the United States, is a federal law that states that any person or entity can be prosecuted if they have submitted fraudulent or false claims for payment from agencies representing the government. According to this act, you cannot knowingly submit a false claim or make a false statement that would lead to a false claim. It contains ‘qui tam’ and ‘whistleblower’ provisions, allowing people who have evidence of specific fraud against a governmental program to sue for payment recovery. Depending on the nature of the case, whistleblowers could receive from 15 to 30 percent of the recovered funds. A False Claims Act attorney should be able to furnish more details.

Origin of this act

Back in 1863, the False Claims Act was instituted to prevent fraud against the government. During the American Civil War, the Union Army received defective ammunition and guns from disreputable contractors and were given inadequate provisions and meals and sick working mules. Later, in 1986, this law was revitalized to scrutinize transactions between the U.S. government and private contractors to deter fraudulent activity. Today, it stands as a vital tool in combating Medicaid and Medicare fraud and has become even more powerful after the introduction of the Fraud Enforcement and Recovery Act of 2009. An experienced false claims lawyer will be able to help you understand the different provisions of this act.

Importance of this act

The False Claims Act holds tremendous importance to healthcare employees and organizations such as those that distribute or sell healthcare services, software, pharma products, technology, or medical devices. It is vital that all the stakeholders recognize and understand FCA boundaries and their implications. While organizations strive to be profitable and productive, it is also crucial that they stay within the limits of the law and prevent fraud at all costs.

Relevance to healthcare services

There are many instances that could lead to an accusation of a false claim, such as prescribing medical services that are unnecessary, unknowingly providing false statements or records, wrongly submitting a claim for certain services or goods to a federal healthcare program, giving inaccurate information about medical products, approving equipment as being tested or operational when it is not up to the required standards, etc. This act also comes into play in cases of double billing, adding different charges together to get increased reimbursement, falsifying test results, using different codes to boost the charges, billing for fake research conducted, not declaring overpayments from the government, not reporting product defects, etc. In all these cases and more, an expert false claims act attorney can be hired to kickstart the legal process.

Whistleblower provision

The False Claims Act makes it possible for ordinary citizens to sue and get incentives for bringing to light any fraud or illegal activity against federal programs. This requires the gathering of relevant evidence to make a strong fraud claim that has necessary merit. A false claims lawyer can help put together a foolproof case to increase the chances that the whistleblower is compensated for his or her contribution to ensuring that justice prevails. The right attorney will also ensure that the whistleblower’s interests are protected.