san francisco fraud attorney

To encourage private citizens to come forward regarding fraud against the government, qui tam cases entitle the citizen, also called the relator, to a portion of any settlement or jury award that arises from his or her evidence and allegations. Individuals can bring qui tam cases under the federal False Claims Act when there is fraud against the federal government or can sue under a state-specific false claims act when the fraud is against the state. However, this award has sometimes led individuals to move forward qui tam suits for profit and not altruistic motives. There may be an even more profound issue when attorneys act as both the relator in a qui tam suit and their own lawyer.

Attorney-Relator Cannot Benefit Twice in Qui Tam Suit in Illinois

This issue came up in Illinois when an attorney brought hundreds of qui tam suits against retailer My Pillow Inc. for failing to collect and remit tax on products sold in Illinois. The attorney acted as both the relator in the suit as well as the attorney. This meant the attorney not only received a portion of the judgment against the company, but he also asked for attorney’s fees.

Health Care Fraud is commonly known by other names such as health insurance fraud, medical billing fraud, health insurance fraud and Medi-Cal Fraud. The complicated and confusing bureaucracy associated with the payment process has lead to authorities accusing innocent providers and beneficiaries of health care fraud. In many instances these are just the result of honest mistakes.

Common Examples of Fraudulent Conduct

Health Care Fraud is an intentional attempt by some providers, and in some cases beneficiaries, to receive unauthorized payments or benefits from the program. This fraud can take many forms, but the most common instances involve knowingly billing for services not performed, billing for more expensive services than the ones the patient actually received (known as “upcoding”), providers billing for the care of more beneficiaries than they can actually serve, and submitting a second duplicate claim for services already paid for.

Articles Tagged with san francisco fraud attorney

Court Finds Attorney May Not Receive Attorney’s Fees in His Own Qui Tam Case

Penalties in California Health Care Fraud