Baltimore Whistleblower Lawyer

The False Claims Act (FCA) is a federal law that allows any person to report fraud against the government. The purpose of the False Claims Act is to identify individuals or companies that receive fraudulent payments from the government. A “False Claim” includes a wide variety of fraud, like:

• submitting false invoices
• making false statements
• submitting false records
• violating government procurement or service contracts,
• over-billing the government for services
• billing the government for services that were unnecessary.

The FCA covers fraud against any government agency, including Medicare and Medicaid, the Department of Defense, Social Security, and many more. Through a lawsuit, the government can recover the taxpayer dollars that were fraudulently taken. 

Importantly, the person who reports the fraud to the government is entitled to a percentage of the recovery. This whistleblower fee is often 15-20% of the total recovery.

Having an experienced attorney help you through the reporting process is very important. The experienced FCA lawyers at Keilty Bonadio have helped the government recover millions of dollars in false claims damages and made sure our whistleblower clients received the maximum amounts possible under the law.

Key Provisions of the FCA

1. Liability for Fraudulent Actions:
   • Submitting a false claim to the government.
   • Causing another party to submit a false claim.
   • Making false records or statements to get a false claim paid.
2. Damages and Penalties:
   • Originally, the FCA mandated double damages and a $2,000 penalty per false claim.
   • Over time, the law has been strengthened to allow treble damages and steadily increasing penalties. This means that if, for example, a company submits “false claims” worth $100,000, the government can recover more than $300,000.
   • The person who reports the fraud to the government is entitled to a portion of the recovery, up to 15 – 20% of the total amount recovered.

Common Examples of False Claims Act Violations

Fraud under the FCA can occur in many forms, including:

• Medically Unnecessary Services: Billing for services that are not medically necessary is a violation of the FCA. For instance, Acadia Healthcare Company Inc. agreed to pay $19.85 million to resolve allegations of billing for medically unnecessary inpatient behavioral health services. Justice Department
• Overbilling and Upcoding: Submitting claims that exaggerate the services provided, known as “upcoding,” is another form of FCA violation. Recently, El Paso Ear, Nose & Throat Associates paid $750,000 to settle allegations of upcoding evaluation and management codes billed to Medicaid and Medicare. Justice Department
• Government Contracting Fraud: Misrepresenting materials or services costs, or lying about a company’s qualifications, in government contracts violates the FCA. Booz Allen Hamilton Holding Corporation paid $377.45 million to resolve allegations of improperly billing commercial and international costs to its government contracts. Justice Department
• Kickback Schemes: Offering or receiving kickbacks for medical referrals reimbursed by federal healthcare programs is prohibited under the FCA. Teva Pharmaceuticals USA Inc. agreed to pay $450 million to resolve allegations of paying kickbacks to increase sales of its drug, Copaxone. Justice Department
• Small Business Contracting Fraud: Some government contracts are set aside from small businesses. When a company misrepresents is status as a small business, it violates the FCA. Paragon Systems Inc. agreed to pay $52 million to settle allegations of causing purported small businesses it controlled to fraudulently obtain small business set-aside contracts. Justice Department

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Impact of the FCA

The FCA is one of the most effective tools for addressing fraud against federal programs. In fiscal year 2019 alone, the United States Department of Justice recovered over $3 billion through settlements and judgments under the FCA.

These cases not only protect taxpayer dollars but also ensure accountability and integrity in government programs and contracts.

Whistleblower Provisions

The FCA includes a qui tam provision, allowing private individuals (known as “whistleblowers”) to file lawsuits on behalf of the government. Whistleblowers who provide information leading to successful recoveries may receive a percentage of the recovered funds as a reward.