False Claims Act Cases: How Qui Tam Plaintiffs Can Fight Laboratory Medicare Fraud
Medicare fraud is a serious issue that affects millions of Americans every year. Unfortunately, laboratory Medicare fraud is one of the most common types of fraud and appears to be on the rise with the increased number of testing facilities and demand for laboratory testing, often through telehealth or remote means. Laboratory Medicare fraud occurs when a laboratory bills Medicare for services that were not provided, or bills for services at a higher rate than what is allowed. Fortunately, the False Claims Act (FCA) provides a powerful tool for qui tam plaintiffs to fight against laboratory Medicare fraud.
What is Laboratory Medicare Fraud?
Laboratory Medicare fraud occurs when a laboratory submits false claims to the government for services that it did not provide or that were not medically necessary. Common types of laboratory fraud include kickbacks, upcoding, unbundling, billing for services that were never performed, billing for more expensive tests than were actually performed, billing for services that should have been bundled together, and billing for services that are not medically necessary.
The Department of Justice (DOJ) has reported several successful False Claims Act (FCA) cases recently against laboratories that have committed Medicare fraud. Most recently, the DOJ announced the unsealing of a case alleging over $107 million in false claims for payment presented to the government for genetic testing. The laboratory involved, Trinity Clinical Laboratories LLC, out of Texas, is accused of having fraudulently billed Medicare and engaged in a conspiracy to utilize kickbacks and bribes.
This most recent case is far from alone and the DOJ has pursued a number of medicare laboratory fraud cases which have in settlements or successful prosecutions, and they serve as a reminder of the importance of reporting fraud and the potential consequences of committing fraud against the government. One of the most recent cases involved the DOJ’s settlement with a laboratory in California. The laboratory had been accused of submitting false claims to Medicare for medically unnecessary genetic testing. The laboratory agreed to pay $3.5 million to resolve the allegations. In another case, the DOJ announced a settlement with a laboratory in Florida which had been accused of submitting false claims to Medicare for medically unnecessary tests. The laboratory agreed to pay $3.3 million to resolve the allegations. The DOJ also announced a settlements laboratories in Texas, Pennsylvania and New York which had been accused of submitting false claims to Medicare for medically unnecessary tests, resulting in over $10 million in recovery. The prevalence of these cases and the DOJ’s acknowledgment of their importance in protecting taxpayer funds is
The False Claims Act And Laboratory Fraud
The False Claims Act (“FCA” provides qui tam plaintiffs with a number of powerful tools to fight against laboratory Medicare fraud. First, the FCA allows qui tam plaintiffs to bring a claim on behalf of the government, even if the government has not yet discovered the fraud. Second, the FCA provides qui tam plaintiffs with a number of legal protections. For example, the FCA prohibits employers from retaliating against qui tam plaintiffs who file a claim. This means that employers cannot fire, demote, or otherwise discriminate against qui tam plaintiffs for filing a claim. Finally, the FCA allows qui tam plaintiffs to receive a portion of the money recovered from the defendant. This means that qui tam plaintiffs can receive a financial reward for their efforts in uncovering and fighting against laboratory Medicare fraud. At our qui tam plaintiff’s law firm, we understand the importance of fighting against laboratory Medicare fraud.The False Claims Act is a federal law that allows private citizens to file a lawsuit on behalf of the government if they have knowledge of fraud against the government. This type of lawsuit is known as a qui tam action. Qui tam plaintiffs, also known as relators, are rewarded for their assistance in recovering money stolen from the government. If the lawsuit is successful, the qui tam plaintiff can receive up to 30 percent of the government’s recovery.
Working with a Qui Tam Plaintiff’s Law Firm
If you have witnessed laboratory Medicare fraud, it is important to work with an experienced qui tam plaintiff’s law firm to protect your rights and ensure that you receive any recovery that is owed to you as a whistleblower. A knowledgeable qui tam plaintiff’s law firm can help you understand the intricacies of the False Claims Act, explain your rights and responsibilities as a qui tam plaintiff, and guide you through the qui tam process. A qui tam plaintiff’s law firm can also help you assess the strength of your case and evaluate the potential rewards if your case is successful.
At Price Armstrong, our qui tam attorneys have extensive experience representing whistleblowers in laboratory fraud cases. If you have information about fraud, you may have a valuable claim as a whistleblower. Contact us today for a free initial consultation and review of your case.
