The False Claims Act (FCA) has been called the government's most successful weapon in the fight against healthcare fraud and abuse (S. Rep. No. 345, 1986). The FCA imposes liability on any person who "knowingly presents...a false or fraudulent claim for payment or approval" to the ...
healthcare context encompasses billing services or items to Medicare or Medicaid “where the service is not actually rendered to the patient, is already provided under another claim, is upcoded, or is not supported by the patient’s medical record.”[61]To ensure compliance with the FCA, the...
Submit your claim Reach out to us for a confidential, encrypted, and free conversation. We are here to listen and help you determine your next steps, no matter what they may be. We get to work on your behalf Our team of seasoned attorneys will fight complex cases on your behalf with pa...
A recent U.S. District Court decision provides a good example of how federal courts will apply the public disclosure/original source rules in whistleblower cases alleging that health care providers violated the False Claims Act.
Call (847) 480-2390 - Rosenblat Law is dedicated to providing our clients with legal services in Healthcare Fraud Defense and False Claims Act cases.
false claim or “allege a pattern of conduct that wouldnecessarilyhave led to submission of false claims to the government.” The relator failed to meet this threshold burden. His complaint contained merely conclusory allegations; it lacked specific factual details about any alleged false claim or ...
If a pharmacy or healthcare provider is aware it is submitting a false claim under Medicare or Medicaid, has deliberately avoided taking steps to determine whether the claim is false, or is aware of a substantial and unjustifiable risk that the claim is false but submits it anyway, the sci...
The total includes approximately $3.2 billion in settlements stemming from the opioid crisis, including the $2.8 billion claim that Purdue agreed to allow in its bankruptcy “to resolve civil allegations that the company promoted its opioid drugs to health care providers it knew were prescribing ...
In these cases, the submitting party is a third-party entity, such as a healthcare provider, whereas the actual defendant in the case is an entity, such as a drug manufacturer, that causes the third party to submit a false claim. Regarding these cases, courts have found that such third-...
A citizen pursuing a claim on behalf of the government is not and does not pretend to be an extension of the Executive Office and, therefore not subject to administrative appointment procedure. Rather the relator is a private person, and the government is a third party to the case. The Vt...