WHAT YOU KNOW MIGHT HELP YOU: FRAUD AGAINST THE GOVERNMENT

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by Jim Orr

Fraud against the government is a lot more common than you might think. For example, government audits have shown that as much as 10% of all Medicare charges are fraudulent.  Medicare fraud can take many forms, such as billing more than once for the same service and charging for services not performed.  Of course, it’s always “we the people” that end up paying for such fraud.  That is, unless the business or person committing the fraud gets caught.

Anyone who has information that a business or person has knowingly submitted or caused the submission of false or fraudulent claims to any branch of the United States government can potentially help file and pursue a lawsuit under the False Claims Act.  The “whistleblower” (called a “relator”) does not have to have been personally harmed at all.  The relator just needs to be aware of the false or fraudulent conduct.

Many states have similar laws to the federal False Claims Act.  The state laws are used when the false or fraudulent claim has been submitted to a state government.

A False Claims Act lawsuit seeks to recover money for the government from the business or person who submitted false or fraudulent claims.  If money is recovered—whether from a settlement between the parties or a court judgment—the whisteblower/relator who helped initiate the lawsuit can potentially recover 15 to 30% of the total amount recovered.  The whistleblower/relator is rewarded to compensate them and their attorney for the hard work involved in pursuing such lawsuits and also to encourage others to come forward with information about false or fraudulent conduct.

The government has recovered billions as a result of False Claims Act lawsuits, and hundreds of millions have been paid to the private citizens–the relators/whistleblowers—who made the lawsuits possible.

There are very specific procedures for filing and pursing a False Claims Act lawsuit.  For example, the suit must be served on the government but must not be served on the defendant until ordered by the court, the suit must be filed under seal and must be supported by a comprehensive memorandum, not filed in court, but served on the government, detailing the factual support for the claim and including copies of relevant documents.   If you have questions about how to pursue a claim under the False Claims Act, please let us know.