Healthcare Fraud Lawyer Blog

February 28, 2020

Reasons Why Most Qui Tam Cases Settle

benjamin-child-17946-copy-300x200 Any time a person needs to file a lawsuit, it is natural to worry about going to court. Most people do not want to face the person they are accusing in court, and just the process of appearing in court often means the case will be quite lengthy, meaning the person bringing the lawsuit will have to deal with the matter for some time. All of these factors hold true in qui tam lawsuits, too. Fortunately, whether you are bringing a lawsuit under the federal False Claims Act or the California False Claims Act, there is a likelihood that the case will settle. Below are just a few of the most common reasons why that is.

Reduce Legal Fees

Going to court always means that there are going to be more legal fees. When attorneys must prepare for court, it involves much more of their time and many lawyers charge higher fees for going to court than for reaching a settlement. The companies accused of making false claims know this and they will often settle to reduce the amount of legal fees they will have to pay because they also have to pay the relator’s legal fees.

February 14, 2020

Who Pays for Attorney Fees in Qui Tam Cases?

by Gregory J. Brod

aidan-bartos-313782-copy-300x200 Just like when filing any lawsuit, whistleblowers are often hesitant to file because they are concerned about attorney fees. Many people think filing a qui tam lawsuit is going to cost a lot of money, and that is enough to prevent them from doing it. This is particularly true when a whistleblower is unsure of the merits of the case. Fortunately, qui tam cases typically do not cost the whistleblower that much, if anything at all. Below are a few of the most common costs whistleblowers think they will face, and how these fees really work.

The Contingency Fee

When you meet with an attorney for the first time to review your case, that consultation will usually be free. This consultation is simply to determine if your case has merit. If it does not, you are not charged anything for that meeting. If it does, the attorney will likely take the case on a contingency fee basis. This means that when the case is over, the attorney will receive a percentage of the compensation you are awarded. You do not have to pay for anything out of pocket. While working your case, the attorney will pay for all expenses including reaching out to expert witnesses, traveling, and completing and filing documentation.

January 31, 2020

Who can be a Plaintiff in a Qui Tam Case?

by Gregory J. Brod

chris-greenhow-662446-unsplash-copy-300x225 Plaintiffs in a qui tam lawsuit are known as relators. The majority of relators are employees who have noticed activity that defrauds the government and violates the federal False Claims Act and the California False Claims Act. Due to the fact that it is mainly employees who file qui tam lawsuits, others sometimes think that they have no right to file these claims. That is not true. Anyone who has observed wrongdoing and fraudulent activity that is not public information can file a qui tam lawsuit. When they do, there are a few things relators in qui tam lawsuits can expect. These facts are found below.

The Complaint is Filed

All qui tam cases begin with the whistleblower filing the complaint. Again, a whistleblower can be anyone who observes wrongdoing. Although it is not required, it is strongly advised that relators speak to a qui tam lawyer who can help with their claim. All lawsuits are complex, but whistleblower lawsuits are some of the most complicated. A lawyer can guide relators through the process and give them the best chance of success.

January 15, 2020

Six Facts Whistleblowers Should Know

by Gregory J. Brod

simon-abrams-286276-copy-300x200 When a person notices that someone else or another entity is defrauding the government through a Medicare scheme or another type of healthcare fraud, that person may often consider blowing the whistle and filing a qui tam lawsuit. These individuals are important because they help make things right and do not only help the government, but also all taxpayers in the country. If you have noticed wrongdoing and want to file a qui tam claim, below are six important facts you should know.

You Need to Act Fast

Many whistleblowers sit on the fact that they saw wrongdoing for a long time. It is important that you do not. In the False Claims Act, there is a rule known as first-to-file. This means that the first person that files the lawsuit will act as the relator and no other claims can be filed. If someone else notices the same wrongdoing and files a claim first, you are barred from receiving compensation for blowing the whistle.

December 30, 2019

What are Safe Harbors Under the Anti-Kickback Statute?

by Gregory J. Brod

aidan-bartos-313782-copy-300x200 Under the federal Anti-Kickback statute, doctors and other healthcare professionals are prohibited from knowingly or willfully paying, offering, soliciting, or accepting remuneration in exchange for patient referrals. Under the statute, it is also illegal to offer something of value or pay for payments of goods and services that healthcare professionals are reimbursed for by the federal government.

The purpose of the law is to protect both patients and the federal government from fraud and abuse by involving money in healthcare decisions. The penalties for violating the Anti-Kickback statute are steep. Healthcare professionals can face up to ten years in federal prison, a fine of $100,000, or both. However, healthcare professionals are also protected by several ‘safe harbors’ under the law. These are provisions that give healthcare professionals immunity from the Anti-Kickback statute. Although there are several safe harbors, the most common are found below.

Investments Interests

November 30, 2019

Five Things You Should Know About Stark Law

by Gregory J. Brod

hush-naidoo-382152-copy-300x200 There are many different types of whistleblower claims that involve physicians and other medical providers defrauding the government. Some of the most common involve Stark Law violations. Stark Law was enacted over two decades ago and was meant to ensure that patients receive the best care possible, and that physicians always work in their best interests. Today, Stark Law has become complicated, and it seems the laws are changing all the time. If you work in the medical industry, below are five things you should know about Stark Law to ensure your employer operates honestly and within the confines of the law.

Stark Law Bans Self-Referrals

When it was enacted in 1989, the concept behind Stark Law was relatively simple. The law was intended to ban self-referrals made by doctors for certain services when a patient was covered through Medicare or another government program. The law was named after Representative Pete Stark, the Democrat from California that sponsored the bill.

November 15, 2019

Common Mistakes Whistleblowers Make

by Gregory J. Brod

amaury-salas-IhXrWDckZOQ-unsplash-copy-300x194 When handled correctly, whistleblower cases can prevent fraud from occurring against the government, help make things right, and even compensate the whistleblower. However, too often these cases fall apart simply because mistakes are made during the process. This is largely because state and federal whistleblower laws are complicated. If you do not understand the laws, it is easy to not follow them correctly and this can lead to mistakes in your whistleblower claim. Below are the most common mistakes made in these cases, so you can avoid making the same ones in yours.

Not Understanding if You Have Protection

The federal False Claims Act and California’s False Claims Act both provide protections for whistleblowers. However, to enjoy that protection, the action that you are reporting on must fall into certain categories. For example, upcoding, kickbacks, billing for services not rendered, and billing for unnecessary medical procedures are all considered actions that may lead to a whistleblower claim. If the actions are not stipulated within the law, you may not have a valid claim.

October 31, 2019

Do You Have a Whistleblower Claim?

by Gregory J. Brod

glenn-carstens-peters-RLw-UC03Gwc-unsplash-copy-300x200 Individuals who believe they have observed someone else defrauding the government often wonder if they have a valid claim. The answer to that is a difficult one, and no one can really determine if a claim is valid without fully analyzing the facts of the case. However, if you believe that you have witnessed someone at your work or elsewhere defrauding the government, below are a few guidelines you can follow to determine if you have a case. Of course, a San Francisco qui tam lawyer can always provide the best advice on whether you have a valid claim.

Is it Just a Hunch?

Qui tam cases are typically more successful when the whistleblower has actually witnessed specific instances of wrongdoing. This is because whistleblowers need specific knowledge that a violation has occurred. That makes it easier to collect evidence, identify the wrongful act, and then pursue the claim. Simply having a hunch or a feeling that someone is doing something wrong usually is not enough to go on to pursue a case.

October 15, 2019

How to Choose a Whistleblower Lawyer

by Gregory J. Brod

benjamin-child-90768-300x200 If you believe you have witnessed someone defrauding the government, there is a chance you have a valid whistleblower claim. Coming forward about the wrongdoing is important. Not only will you serve the country by making things right, but you could also receive compensation if your claim is successful. However, these claims are some of the most challenging lawsuits to pursue. To give your claim the best chance of a positive outcome, it is important to speak to a San Francisco whistleblower lawyer. Choosing that lawyer is also essential, as you want to ensure that you work with someone who has the necessary experience and skills. Below are a few ways you can ensure you are working with the right attorney for your claim.

The Lawyer’s Area of Expertise

Sometimes attorneys will post one page on their website stating that they have expertise with whistleblower claims. However, the rest of their site may be dedicated to other areas of law. When this is the case, there is a good chance the attorney does not have the necessary expertise with whistleblower lawsuits. Look for attorney websites that do not just have a whistleblower practice page, but also plenty of blog posts and other information related to whistleblower claims. This will ensure you are working with a whistleblower attorney in San Francisco who has the necessary experience with the False Claims Act, the Whistleblower Protection Act, and other important pieces of legislation.

September 30, 2019

What do You have to Prove in a Qui Tam Lawsuit?

by Gregory J. Brod

rawpixel-760036-unsplash-300x289 Under the False Claims Act, an individual or agency can be held liable if they knowingly submit a false claim to the government, or cause the submission of a false claim. When individuals see these wrongdoings and false claims being made, they can pursue a whistleblower lawsuit to correct the wrong. Like any lawsuit though, they will need to provide certain proof before a lawsuit can proceed. The two elements of proof in these lawsuits are that the claim must have been made knowingly, and it must have been false or fraudulent.

Knowingly Making a False Claim

Defendants cannot only be held liable for submitting a false claim, they can also be held liable if they intended to submit one, even if they never did. However, the false claim must be made by a person with full intention of defrauding the government. Simple negligence or innocent errors are not enough to hold a person liable for the fraudulent act.