Nationwide Qui Tam Litigation, Healthcare Fraud, Medicaid & Medicare Billing Fraud

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Articles Published by Berg & Androphy

 Georgia Taxpayer Protection False Claims Act

The Georgia Taxpayer Protection False Claims Act (GTPFCA) went into effect on July 1, 2012. The GTPFCA models the federal FCA, but also contains some provisions that are unique. - [1]—Liability and Damages Provisions - The liability and damages provisions under the GTPFCA are similar to those under the federal FCA. For example, an individual will be liable for knowingly presenting or causing the presentation of a false or fraudulent claim for payment or approval, or...

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 Indiana False Claims and Whistleblower Protection Act

Indiana passed the Indiana False Claims and Whistleblower Protection Act (IFCWPA) in 2005. The IFCWPA generally models the federal FCA, but contains some differences. [1]—Liability and Damages Provisions - Generally, an individual will be liable under the IFCWPA for the same violations as the federal FCA. For example, an individual will be liable for knowingly or intentionally presenting a false claim to the state for payment or approval, or...

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 Illinois Whistleblower Reward and Protection Act

Illinois passed the Illinois False Claims Act (IFCA), previously called the “Illinois Whistleblower Reward and Protection Act,” in 1991. The IFCA models the Federal False Claims Act (FCA), but is different is some aspects. 1]—Liability and Damages Provisions - Generally, an individual will be liable under the IFCA for the same violations as the federal FCA.

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 Colorado Medical Assistance Act

Colorado’s version of the Federal False Claims Act (FCA)2 is the Colorado Medical Assistance Act (CMAA).3 It is also known as the “Colorado Medicaid False Claims Act.”4

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 Connecticut False Claims Act

The Connecticut False Claims Act (CFCA)2 is Connecticut’s version of the Federal False Claims Act (FCA).3 The federal and state statutes are similar in many aspects, but there are some differences between the two.

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 Delaware False Claims and Reporting Act

The Delaware False Claims and Reporting Act2 generally models the Federal False Claims Act (FCA)3. - 1. Liability and Damages Provisions - The liability and damages provisions under the DFCRA are similar to those under the federal FCA. Generally, an individual will be liable under the DFCRA for the same violations as the federal FCA.

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 Georgia False Medicaid Claims Act

Georgia’s version of the Federal False Claims Act (FCA)2 is the Georgia False Medicaid Claims Act (GFMCA).3 The statute was recently amended to look more like its federal counterpart. The changes became effective on July 1, 2012. Generally, the GFMCA models the federal FCA, although there are some differences.

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 Hawaii False Claims Act for False Claims to the State

Hawaii’s state version of the federal False Claims Act (FCA)2 is the Hawaii False Claims Act for False Claims to the State (HFCAS).3

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 The Intersection of the Dodd-Frank Act and the Foreign Corrupt Practices Act

What All Practitioners, Whistleblowers, Defendants, and Corporations Need to Know

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 Prevailing Wage Laws and the False Claims Act

Prevailing wage laws(1) require that contractors and subcontractors who obtain certain government construction and service contracts pay their employees a local minimum amount, commonly referred to as the “prevailing wage.” By: Joel M. Androphyi and Rachel L. Grier

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 Defense Contractor Fraud

The False Claims Act (“FCA”) is particularly important in the area of defense contracts. In fact, the FCA was enacted due to the sever abuses which occurred at the hands of many defense contractors and corrupt officials who fraudulently procured payment for the necessities of war, such as ships, food, supplies, and weapons, to the detriment of the United States military.(1) By: Joel M. Androphyi and Rachel L. Grier

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 Gathering Evidence in Qui Tam Actions

Qui tam whistleblowers first discover fraud against the government in a variety of different ways; some learn it from a business owner’s own statements while others witness it in caring for a patient who has patently not received a billed-for treatment.

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 District of Columbia Procurement Reform Amendment Act

The District of Columbia passed the Procurement Reform Amendment Act (“PRAA”) in 1996.2 In 1997, it passed the Emergency Amendment Act, which increased the penalties of the PRAA’s civil false claims and added qui tam provisions.3 The PRAA models the FCA, but also contains some provisions that are unique.

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 New York City False Claims Act

On May 19, 2005, Mayor Michael Bloomberg signed the New York City False Claims Act (the “NYCFCA”) into law.2 The NYCFCA became effective on August 19, 2005 and will remain in effect until June 1, 2012.3 New York City passed the ordinance because the city distributes funds through “one of the largest budgets in the United States” and the payment of false or fraudulent claims has “considerable impact upon the city’s treasury.”

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 Florida False Claims Act

The Florida False Claims Act was enacted in 1994.(1) The liability and damage provisions of the Florida FCA are identical to its federal counterpart, except for two key differences. This article will explain the key differences in this legislation and the various procedural requirements.

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 California False Claims Act

California has independent qui tam laws and procedures. The California False Claims Act (the “CFCA”) was enacted in 1987, making it one of the oldest state false claims act. Numerous cases have been litigated pursuant to the California False Claims Act (the “California FCA”)1. Thus, California courts have had ample opportunity to interpret provisions of the California FCA.

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 Survey of Penalties and Damages in False Claims Act Cases

Because Section 3729(a) of the FCA requires courts to impose a penalty for each false claim, inevitably cases will exist in which courts must hold FCA defendants liable for substantial penalties even where actual damages to the government are minimal or nonexistent.

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 Survey of Damages in False Claims Act Retaliation Cases

The FCA protects a potential relator from retaliation for “lawful acts done . . . in furtherance of an action under this section, including investigation” and provides “all relief necessary” to make him or her “whole.”

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 False Claims Act Penalties

The 1986 amendments set the range of civil penalties for violations of the False Claims Act (“FCA”) from $5,000 to $10,000, in addition to trebling actual damages.

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 False Claims Act Damages

The FCA was enacted to provide restitution to the Government for losses sustained as a result of fraud. The statute authorizes the award of actual damages and civil penalties to ensure that the Government is made whole for losses caused by fraudulent acts.

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 Fraudulent Medical Billing and the False Claims Act

Although the FCA was first enacted with dishonest defense contractors in mind, the FCA has become an effective weapon to fight healthcare fraud. Categories of facility healthcare fraud often involve allegations of total neglect or no services, worthless services, inadequate and inferior services and products, and aggressive patient treatment. [1]

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 Best Value and the False Claims Act

Background There are several types of Capital Medical Equipment (“CME”) that are routinely sold to hospitals and healthcare organizations, including Magnetic Resonance Imaging Scanners (“MRI”), Computed Tomography Scanners (“CT Scanners”), and ultrasound equipment. These products represent a major portion of CME purchases that hospitals and healthcare organization make each year.

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 Pharmaceutical Best Price Obligations and the False Claims Act

Federal law proscribes that drug manufacturers pay rebates to the states to insure that the Medicaid program is receiving the best price on covered drugs. When manufacturers determine the best price, they must include cash discounts, free goods, volume discounts, and rebates given on the covered drug. [1]

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 Government Procurement Fraud and the False Claims Act

General Comments Contracts with the Government can encompass a variety of agencies and departments. Many of the reported cases involve contracts with the Department of Defense (“DOD”), the Department of Veterans Affairs (“DVA”), the Department of Housing and Urban Development (“HUD”), the National Aeronautics and Space Administration (“NASA”), and the General Services Administration (“GSA”), among other procuring agencies.

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 Defective Medical Devices and the False Claims Act

Federal and state laws require medical devices shipped and sold in the United States to be safe, effective, and reliable, and to perform as represented and to specifications. Medical device manufacturers are subject to mandatory and stringent controls over product design, manufacture, process changes, rework, specifications, specifications changes, and quality control. [1]

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 The Criminal Cloud over S.E.C. Investigations of Insider Trading

Your client, a respected real estate attorney, receives a subpoena duces tecum from the Securities and Exchange Commission (S.E.C.) requesting all documents relating to her purchase and sale of the stock of X.Y.Z., Inc.

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 Federal Qui Tam Litigation: The Governement's Watchdog

"If there has been any crime, it must be prosecuted. If there has been any property of the United States illegally transferred or leased, it must be recovered. . . . I propose to employ special counsel of high rank drawn from both political parties to bring such actions for the enforcement of the law.” Calvin Coolidge, Statement on the Teapot Dome Scandal.

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