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Lowther | Walker’s False Claims Act attorneys have over 20 years of experience representing defendants, including life sciences companies, medical providers, government contractors and educational institutions nationwide.
We help clients mitigate risk and comply with regulatory frameworks in the False Claims Act and associated federal fraud and abuse laws.
Our False Claims Act defense services include client representation for:
Our FCA lawyers have represented clients under False Claims Act charges in federal courtrooms.
Book your free, confidential consultation online or call (404) 496-4052 to discuss your False Claims Act case with an attorney.
No-obligation. Fully confidential.
Call Us Today: (404) 496-4052
Investigation terminated; no prosecution. DOJ notified our client, the CEO of a major hospital network, that he was the target of a multi-million-dollar healthcare fraud investigation related to “Medicare upcoding” that the FBI and HHS-OIG […]
The FBI and the HHS-OIG investigated our client for Health Care Fraud based on the client’s submitting over $7 million in alleged false claims to Medicare. The Government indicted our client on Conspiracy to commit […]
HHS-OIG investigated our client for Healthcare Fraud and Aggravated Identity Theft based on the client’s allegedly participating in a “telemedicine” kickback scheme that defrauded Medicare of approximately $30 million in reimbursements for not-medically-necessary durable medical […]
A private insurance company discovered that our client, a dentist, fraudulently billed it, various other insurance companies, and federal health care benefit programs for approximately $400,000 of services that our client did not provide. We […]
The Department of Justice’s Criminal Division, Fraud Section charged our client and nine other individuals in a $1.4 Billion health care fraud, wire fraud, and money laundering conspiracy (the largest health care fraud case that […]
Investigation terminated; no prosecution. DOJ notified our client, the CEO of a major hospital network, that he was the target of a multi-million-dollar healthcare fraud investigation related to “Medicare upcoding” that the FBI and HHS-OIG […]
The FBI and the HHS-OIG investigated our client for Health Care Fraud based on the client’s submitting over $7 million in alleged false claims to Medicare. The Government indicted our client on Conspiracy to commit […]
HHS-OIG investigated our client for Healthcare Fraud and Aggravated Identity Theft based on the client’s allegedly participating in a “telemedicine” kickback scheme that defrauded Medicare of approximately $30 million in reimbursements for not-medically-necessary durable medical […]
A private insurance company discovered that our client, a dentist, fraudulently billed it, various other insurance companies, and federal health care benefit programs for approximately $400,000 of services that our client did not provide. We […]
The Department of Justice’s Criminal Division, Fraud Section charged our client and nine other individuals in a $1.4 Billion health care fraud, wire fraud, and money laundering conspiracy (the largest health care fraud case that […]
The False Claims Act (31 U.S.C. § § 3729-3733) prohibits individuals or entities from submitting inaccurate claims to a government payer (i.e., Medicare, Medicaid).
Healthcare entities violate the False Claims Act by knowingly presenting a false or fraudulent claim to one of these programs or causing a false claim to be presented.
Department of Justice (DOJ) data reveals that 80% of the $11.4 billion recovered over the last 4 years under the False Claims Act involved “health care fraud matters”. The federal statute was enacted to encourage private citizens to identify fraud in federal programs, including Medicare and Tricare.
The False Claims Act serves to combat fraud within federal programs and contracts by incentivizing whistleblowers under qui tam lawsuits to come forward with information on suspected fraud and abuse by federal healthcare providers.
Entities guilty of defrauding the government under the FCA face serious penalties, including treble charges, which multiply the government’s damages by three. Additional penalties for False Claims Act convictions include excluding the medical provider from federal programs.
Anyone who knowingly submits or causes submission of a false or fraudulent claim to the United States government faces a fine of up to $11,000 per false or fraudulent claim.
Healthcare providers who intentionally submit false claims to the government, with knowledge the claims were false, fraudulent or fictitious can face up-to five years imprisonment. Each individual also faces fines of up-to $250,000 and companies are subject to fines of $500,000 for a federal felony False Claims Act conviction. Misdemeanor penalties include fines of $100,000 for an individual and $200,000 for a company, per claim. Suspicions of fraud will immediately trigger an audit by an investigator who may then recommend action, such as payment suspensions, to the Department of Justice. If your organization receives an audit request signed by a fraud investigator, you may wish to begin building your legal defense by hiring a healthcare fraud attorney. In cases where data auditors find issues such as billing irregularities, the next step will be requesting records.
The False Claims Act attorneys at Lowther | Walker represent clients nationwide and have won landmark results through a diligent approach to FCA defense. Our defense work involves:
We initiate a review of all case documentation and prioritize early intervention to help limit the potential for criminal penalties and government enforcement. Our experienced team will harness their decades of experience in defending fraud cases to determine the intentions of prosecutors and use their discretion to resolve the matter.
Our knowledge of The False Claims Act and case enforcement means we can address prosecutors directly on the lack of merit to the case. Our attorneys will help prove that the case should not be pursued any further by the federal government.
In cases with compelling evidence against our clients, we can help limit their exposure to significant FCA penalties.
Minor billing issues, such as the submission of an inaccurate invoice do not alone constitute fraud under the False Claims Act. Allegations made by the relator must substantiate the findings of a specified level of intent.
Under the FCA, the government must prove that the defendant should have known the alleged fraudulent activity occurred. Defendants can work with their FCA lawyers to prove they did not know about the fraudulent activity, and therefore, their case should be dismissed.
Relators in qui tam lawsuits under the False Claims Act must adhere to the Federal Rules of Civil Procedure (FRCP). Any technical or procedural issues with their case may call into question the case’s validity.
Defense lawyers can help pinpoint a lack of FRCP compliance and weaken the prosecution’s case. This process may cause the government to question whether they wish to use its finite resources in pursuing the claim. Criminal defense attorneys play a critical role at this early stage, helping call into question the validity of the qui tam lawsuit and supporting the dismissal of all charges.
Our courtroom-proven lawyers will defend you against False Claims Act charges. We’ve built a reputation throughout the United States for our proven track record winning complex cases through diligent analysis.
Call Lowther | Walker via (404) 496-4052 and book a free, no-obligation consultation with your False Claims Act lawyer.
No-obligation. Fully confidential.
Call Us Today: (404) 496-4052
The FCA is unique because of its qui tam provisions, which allow private individuals (known as “relators” or “whistleblowers”) to file lawsuits on behalf of the government and receive a percentage of any recovery. No other federal statute offers such incentives.
FCA claims must be brought within either 6 years from the violation date or 3 years after the government knows or should have known about the violation, but no more than 10 years after the violation, whichever is later.
When a defendant’s interpretation of the FCA is reasonable, even if ultimately incorrect, courts may find the defendant lacked the scienter (knowledge) required for FCA liability. This safeguards against imposing liability for reasonable efforts to comply with complex regulations.
Federal courts increasingly recognize medical judgments regarding the necessity of treatment involve subjective medical determinations. To be “false” under the FCA, many courts require proof that the judgment was objectively false or that no reasonable physician could have reached the same conclusion.
A company should immediately implement a litigation hold to preserve relevant documents, assemble legal counsel and conduct a preliminary internal investigation, evaluate insurance coverage, and develop a communication strategy for stakeholders.
