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Now reviewing: reports of billing fraud in federal health programs. Read how reporting works.
Now reviewing: reports of billing fraud in federal health programs. Read how reporting works.
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Strathmore Law
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Write privately

False Claims Act

When public money is the victim

A federal law lets a private person file a case on the government’s behalf against a company that overbilled, misstated or cheated a public program. It is called a qui tam case, and it begins under seal.

I take these from people who saw the billing, the contract or the paperwork from the inside: where the claim was submitted, and why it was not true.

Not every concern is a case. I will tell you early which side of that line yours is on.

Where it tends to show up

  • Billing a federal health program for care that was not given or not needed

  • Charging more than a contract allows, or delivering less than it promised

  • Misstating size or status to win a set-aside contract

  • Misusing grant or program funds

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Two brown concrete government office buildings behind street trees at a city intersection, in coarse halftone dots

Three places I look first

  • Healthcare billing

    Coding that does not match the care, referrals that are paid for, and services billed that were never provided.

  • Government contracting

    Pricing the contract did not allow, parts that were not what was ordered, and tests that were signed off without being run.

  • Grants and program funds

    Money awarded for one purpose and spent on another, and eligibility that was claimed but not met.

Qui tam, briefly

What under seal means

Why is the case filed under seal?

So the government can look at it quietly before the company hears of it. The seal usually lasts for months, and it protects you as well as the investigation.

What does the government do with it?

It investigates and then decides whether to join the case. If it declines, you may still be able to go on, and I will tell you what that would involve before you choose.

Who receives any recovery?

The government receives most of it. If the case succeeds, the person who brought it can receive a share the statute sets within a range, and that share is separate from my fee.

Tell me what the paperwork showed.

One note, in a few lines, from a personal device. I will say whether it is a matter I can take.

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Contingency fee: no fee unless there is a recovery. Case costs are explained in writing before you sign.