Enacted during the Civil War, the Federal False Claims Act was originally designed to help the Federal Government stem the tide of fraudulent and unscrupulous weapons appropriations being made by industrial suppliers in the industrial North. This law was originally meant to deal with the particularly inflated costs of food for the Army during the war. However, because of the language of the Law, its purview has grown to cover any and all fraudulent claims made against the United States.
Due to the steady aging of the population of the United States, as well as the recent swell in the prices of healthcare and health insurance, Federal False Claims Act actions, also known as Qui Tam actions, have increasingly been focused on Healthcare Fraud. In fact, of the over TEN BILLION Dollars recovered by the Federal Government over the last three years, nearly 80% of it has been from healthcare fraud. This quantum shift from military appropriations to healthcare is a signal of the changes in our society, and the legal system upon which it rests.
Because of the steady increase in health insurance prices over the last decade, it has become increasingly lucrative for disreputable companies and healthcare professionals to attempt to defraud the government. This is accomplished in numerous ingenious ways, but perhaps the most common is the practice of “up-coding,” or ordering procedures or implants which are unnecessary for those patients with good health insurance. This process is further incentivized by inappropriate relationships between physicians and medical device and pharmaceutical manufacturers, in which doctors or other healthcare professionals are improperly and unethically rewarded by large manufacturers for using their products.
Since a significant number of these cases involve people on government insurance plans, government employees, or occur in facilities receiving public funding, the Federal Government has a vested interest in seeking them out and prosecuting them. These violations cost the government billions in taxpayer money and are responsible for a significant portion of taxpayer debt. The Federal government has incentivized qui tam reporting in many ways, the greatest of which is to ensure whistleblower anonymity through sealed prosecution, and to allocate a percentage of the recovered monies to the whistleblower as a reward for preventing fraud.
While it may seem like this kind of federal action takes place far away in some lofty executive boardroom, it is actually far more common on a local, and personal, level. Your employer, your pharmacy, and even your doctor may be actively or passively defrauding the government. These local instances are combined to build larger cases of fraud by the federal government, so they need, by law, attorney intervention. Therefore, in order to recover for reporting in a qui tam action, individuals must have legal representation. This saves the government time and money by ensuring that these qui tam cases are legitimate and pursuable.
If you, or anyone you know, has any knowledge of potential attempts to defraud the government, do not hesitate to contact the experienced litigators of Dolman Law Group.
Dolman Law Group
800 North Belcher Road
Clearwater, FL 33765