False Claims Act Litigation

How does False Claims Act litigation affect companies?

False Claims Act (FCA) litigation is a type of legal action where individuals, organizations, or businesses can be held liable for submitting false or fraudulent claims for payment to the government. The FCA provides incentives for whistleblowers to come forward and report fraudulent claims, with the potential to receive a share of any money recovered. In bet-the-company litigation, FCA litigation can have significant consequences such as facing substantial penalties charges, exclusion from government contracts, or even criminal charges.

FCA litigation can arise from various situations. Some examples include healthcare fraud and defense contractor fraud. Healthcare fraud involves individuals submitting false claims for services not rendered or not medically necessary. Need help regarding False Claims Act litigation? Schedule your consultation today with a top healthcare attorney.

In Florida, which laws and regulations apply to False Claims Act litigation compliance? The False Claims Act (31 U.S.C. §§ 3729-3733) is a federal law that applies nationwide. However, many states, including Florida, have enacted their own False Claims Acts that mirror the federal law. In Florida, the Florida False Claims Act (Florida Statutes Sections 68.081-68.092) governs FCA litigation and provides additional penalties for violations related to state funds. Other related federal laws include the Anti-Kickback Statute, which prohibits offering or receiving kickbacks in exchange for referrals, and the Stark Law, which prohibits physicians from referring patients to entities in which they have a financial interest.

What are common issues regarding the False Claims Act that lead to litigation?

Several common issues regarding FCA that lead to litigation include:

· Falsifying Information: One of the most common situations that lead to litigation under the False Claims Act is when a company knowingly submits false or fraudulent claims for payment to the government. Examples may include situations where a company bills the government for undelivered services or products or over-represents the amount of a delivered product.

· Kickbacks and Bribery: Another common situation that leads to FCA litigation is when companies offer or accept kickbacks and bribes in exchange for business. Examples include healthcare providers receiving kickbacks for prescribing certain drugs or contractors receiving kickbacks for awarding government contracts to specific suppliers.

· Failure to Disclose: Companies can also face litigation under the False Claims Act if they fail to disclose information required by the government to receive payment. For example,

a company that receives federal grant money but fails to disclose conflicts of interest or other relevant information may be subject to FCA litigation.

· Certification of Compliance: Companies can also face litigation under the False Claims Act if they falsely certify compliance with government regulations or requirements. For example, a healthcare provider that certifies compliance with Medicare regulations but fails to meet those regulations may be subject to FCA litigation.

We are value-based attorneys at Jimerson Birr, which means we look at each action with our clients from the point of view of costs and benefits while reducing liability. Then, based on our client’s objectives, we chart a path to seek appropriate remedies. To determine whether your unique situation may necessitate litigation, please contact our office to set up your initial consultation.

What steps should businesses take to minimize the risk of litigation over False Claims Act litigation?

To minimize the risk of litigation over FCA violations, businesses should take several proactive steps:

· Implement Robust Compliance Programs: Develop and implement comprehensive compliance programs that include written policies, procedures, and training on FCA regulations. Ensure that employees understand their obligations under the FCA and are trained to identify and report potential violations.

· Conduct Regular Audits and Monitoring: Regularly audit billing practices, coding procedures, and documentation to identify any potential FCA compliance issues. Implement monitoring systems to track claims submissions and reimbursements, and promptly address any discrepancies or red flags.

· Maintain Accurate and Transparent Billing Practices: Ensure that billing practices are accurate, transparent, and supported by proper documentation. Avoid billing for services not rendered, upcoding, unbundling, or other practices that could be construed as fraudulent under the FCA.

· Provide Ongoing Training and Education: Continuously educate employees on FCA regulations, compliance requirements, and ethical billing practices. Provide regular training sessions, updates on regulatory changes, and case studies to reinforce compliance awareness throughout the organization.

· Establish Clear Reporting Mechanisms: Implement clear channels for employees to report suspected FCA violations or compliance concerns without fear of retaliation. Encourage employees to report potential issues internally, and promptly investigate and address any reported concerns.

· Respond Promptly to Compliance Concerns: Take immediate action to investigate and address any reported compliance concerns or potential FCA violations. Implement corrective measures as needed, including disciplinary action, process improvements, and restitution if appropriate.

· Promote a Culture of Compliance: Foster a culture of compliance within the organization by emphasizing the importance of ethical conduct, transparency, and integrity in all

business operations. Encourage leadership to set a positive example and prioritize compliance efforts at all levels of the organization.

· Stay Informed and Up-to-Date: Stay informed about changes in FCA regulations, enforcement trends, and industry best practices through regular monitoring of regulatory updates, industry publications, and guidance from regulatory agencies. Adapt compliance strategies and procedures accordingly to mitigate emerging risks.

Frequently Asked Questions

What are the penalties for violating the False Claims Act?

Penalties for violating the federal FCA include treble damages plus fines of $11,000 per false claim submitted. Additionally, individuals found guilty of violating the False Claims Act may be excluded from participating in federal healthcare programs and may face criminal charges and imprisonment.

Can an individual file a lawsuit under the False Claims Act, or can only the government file?

Individuals can file lawsuits under the federal and Florida False Claims Acts, known as qui tam lawsuits. Qui tam lawsuits allow individuals who have knowledge of fraud committed against the government to bring a lawsuit on behalf of the government. If the case is successful, the individual may receive a portion of the damages awarded to the government.

Are there protections for whistleblowers in the False Claims Act?

Yes, the False Claims Act includes provisions to protect whistleblowers from retaliation by their employers for reporting fraud. Whistleblowers who suffer retaliation may be entitled to reinstatement, back pay, and other remedies under the law.

Have more questions about False Claims Act litigation?

Crucially, this overview of False Claims Act litigation does not begin to cover all the laws implicated by this issue or the factors that may compel the application of such laws. Every case is unique, and the laws can produce different outcomes depending on the individual circumstances.

Jimerson Birr attorneys guide our clients to help make informed decisions while ensuring their rights are respected and protected. Our lawyers are highly trained and experienced in the nuances of the law, so they can accurately interpret statutes and case law and holistically prepare individuals or companies for their legal endeavors. Through this intense personal investment and advocacy, our lawyers will help resolve the issue’s complicated legal problems efficiently and effectively. Having a Jimerson Birr attorney on your side means securing a team of seasoned, multi-dimensional, cross-functional legal professionals. Whether it is a transaction, an operational issue, a regulatory challenge, or a contested legal predicament that may require court intervention, we remain tireless advocates at every step. Being a value-added law firm means putting the client at the forefront of everything we do. We use our experience to help our clients navigate even the most complex problems and come out the other side triumphant.

If you want to understand your case, the merits of your claim or defense, potential monetary awards, or the amount of exposure you face, you should speak with a qualified Jimerson Birr

lawyer. Our experienced team of attorneys is here to help. Call Jimerson Birr at (904) 389-0050 or use the contact form to schedule a consultation.