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Medicare Qui Tam Defense Attorney

Healthcare providers are subject to myriad rules and regulations. Any misstep can be characterized as not just a regulatory mistake, but as a deliberate act to defraud patients, insurance providers, or government entities. Submitting false, inflated, or otherwise problematic bills to Medicare can lead to heavy fines, license revocation, and even criminal prosecution.

In order to root out Medicare fraud, the federal and California state legislatures have passed laws that essentially deputize healthcare workers who identify alleged fraud. Whistleblowers who believe that a healthcare practice is engaged in fraudulent billing practices targeted at government insurance providers can bring their own claims in court. The aim of these whistleblower or qui tam actions is to take the burden of enforcement off of government agencies. Whistleblowers are incentivized by being offered bounties for successful claims.

A Medicare qui tam defense attorney at the Law Offices of Art Kalantar is ready to protect you and your company from allegations of fraud and abuse. We have a deep understanding of healthcare laws and how they pertain to the healthcare industry. Through our decades of experience in the healthcare industry, we know how to mount the strongest defense against Medicare fraud allegations. We may be able to prove that the accusations against you are based on misunderstandings, harmless errors, exaggerations of the truth, or outright fabrications built by a competitor or peer for their own gain.

The False Claims Act and Qui Tam

The federal False Claims Act (FCA) permits private citizens to pursue legal action against parties who have committed alleged fraud against the government. When a private citizen brings a legal claim on behalf of the government, it is known as a “qui tam” action. Often, these actions are brought by employees of the healthcare practice (nurses, radiologists, billing managers, etc.). These whistleblowers can collect a hefty bounty for bringing their claims, in some cases up to 30% of the ultimate judgment or settlement. The California False Claims Act also permits individuals to bring qui tam actions for fraud committed against California authorities such as Medi-Cal.

Medicare Qui Tam Actions

Commonly, qui tam actions are based on alleged Medicare fraud. Common types of Medicare fraud alleged in these qui tam actions consist of overbilling, upcoding (billing for more expensive services than those provided), duplicate billing, unbundling (billing services separately that are typically grouped), phantom billing, and waiving unqualified Medicare co-pays and deductibles.

Federal and state laws protect whistleblowers from retaliation. Employers cannot take adverse employment action against employees who report or take action regarding unlawful conduct, including Medicare fraud.

If You Face a Qui Tam Action, You Need a Strong Legal Defense

The fact that the lawsuits are brought by private citizens does not make the qui tam actions any less serious for health care defendants. Defendants found liable under the federal FCA can face civil penalties from $5,000 to $10,000 as well as up to three times the amount of actual damage caused to the government (i.e., three times the amount fraudulently billed to Medicare). Defendants to a California False Claims Act case can face penalties of $5,500 to $11,000 as well as triple the amount of actual damages caused.

A seasoned healthcare fraud and qui tam defense attorney can help you mount a proper defense to fraud allegations and take appropriate action to mitigate the incidence of any future billing errors or other issues. An allegation from an alleged whistleblower should not bankrupt your healthcare practice. The zealous Medicare fraud defense attorneys at the Law Offices of Art Kalantar are here to help.

Seasoned Advice and Zealous Representation Against Medicare Fraud Allegations

After being accused of Medicare fraud or other forms of healthcare abuse, you must tread carefully, as your reputation and business could be in jeopardy. Even an unsuccessful claim can tarnish your professional reputation. A successful claim can lead to thousands of dollars in fines and affect your professional licensing. At the Law Offices of Art Kalantar, our healthcare industry lawyers are ready to provide uncompromising, aggressive legal defense, as well as the considered advice and guidance you need.

Call 310-773-0001 at any time to request a free case evaluation with the Law Offices of Art Kalantar in Beverly Hills.

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